Autograph Request Form
Organization (If personal, please indicate)
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Contact Name
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First Name
Last Name
Email
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example@example.com
Confirm Email
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example@example.com
Phone Number
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Please include area code
Delivery Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
This Request is:
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Please Select
Charitable
Educational
Institutional
Personal
If applicable, is the organization labeled a 501(c) nonprofit agency?
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Yes
No
What age group does this organization benefit?
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K-6th Grade
7th-8th Grade
High School
Adult
For what type of activity would this item be used for?
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Will money be raised?
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Yes
No
If yes, where will the proceeds go/be used for?
When does your event take place? DUE TO A LARGE VOLUME, THE TIMING OF AUTOGRAPH REQUEST FULFILLMENTS CANNOT BE GUARANTEED
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-
Month
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Day
Year
Date
Will there be commercial sponsorship or co-sponsorship for this event?
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Yes
No
If yes, how will the commercial entity be involved?
Will there be any advertisements or promotion by a commercial agency?
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Yes
No
If yes, please explain.
How many items are you requesting?
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Please Select
1
2
Which autograph item are you requesting?
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Please Select
Signed Brad Brownell photo
Signed Erik Bakich Photo
Signed Amanda Butler Photo
Signed Mike Noonan Photo
Signed Eddie Radwanski photo
Signed Jackie Simpson Kirr photo
Signed John Rittman photo
Other
If you selected other, what item(s) will you be sending in? Please note that we do ask that you limit your request to 1-2 items. Any requests over will not be approved.
What personalization would you like on your item(s)?
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By typing your full name below, you are consenting to the above "Guidelines for Autograph Items."
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By typing your full name below, you are consenting to the above "NCAA Bylaws Regarding Promotional Activities."
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Any additional NOTES
Enter the message as it's shown
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Submit
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