Altrusa International, Inc. of Northeastern Connecticut

Hats Off Auction Registration

Name ____________________________________________________________________________________

Address ________________________________________________________________________________

City _______________________________________ State ______________ Zip ____________

Need Separate Bid Number? Y/ N

Name of guests __________________________________________________________________ Y / N

__________________________________________________________________ Y / N

Number of people attending _____ @ $40 each total Amount enclosed $ ___________

I cannot attend, but would like to make a tax deductible donation of $ ___________

$250 sponsor, $200 silver donor, $150 Bronze donor, Other $ ___________

Make check payable to Altrusa International, Inc. of Northeastern Connecticut and mail to