Proxy Bid Form

Please fax completed form to: 707-967-3392 or email to: ann@sthms.org

Faxes must be received no later than 12:00 noon on Friday, March 3, 2017.

For further information, please call Ann Roggenbuck at 707-963-1527

Online catalog available late February: www.sthms.org/festa

Shipping Address:

Name:                 _________________________________________________________

Address:             _________________________________________________________

City/State/Zip:    _________________________________________________________

Phone #:              _________________________________________________________

Fax #:                  _________________________________________________________

Email Address:   _________________________________________________________

Billing Address (if different):

Name:                 _________________________________________________________

Address:             _________________________________________________________

City/State/Zip:    _________________________________________________________

Phone #:              _________________________________________________________

Fax #:                  _________________________________________________________

Credit Card (please check one):    American Express    MasterCard    VISA

Name on Card:  ___________________________________  Number: ________________________________

Signature:  _____________________________________________  Exp. Date:  _______________