Autographed Item Request Form

Autographed Item Donation Request Form

Beneficiary Organization’s Name *

Organization’s Website *

Organization’s Mission *

Organization’s Tax ID Number *

Upload Organization’s W-9 Form *

No File Chosen

File uploads may not work on some mobile devices.

Organization’s Address *

Address Line 1

Address Line 2

City

State

ZIP Code

This organization serves people in (check all that apply) *

Greater Cincinnati Greater Dayton Greater Columbus Southeastern Ohio Southern Indiana Kentucky

Other:

Please describe how/if this organization’s mission coincides with the Bengals community pillars. *

Have the Bengals donated to this organization in the last 12 months? *

Requestor’s Name *

First Name

Last Name

Requestor’s Title *

Requestor’s Phone *

Requestor’s Email *

Event Name *

Event Date *

Event Website*

Number of Anticipated Guests at Event *

Donated item will be used for:*

Silent Auction Live Auction Raffle

Other:

If Other, please explain. *

Is this organization’s office located within 25 miles of Paycor Stadium? *

Preferred Delivery Method:*

Pick Up from Paycor Stadium USPS to Organizations Address

*If within 25 miles of Paycor Stadium, item must be picked up.