Affiliate name * Date items needed by * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202120222023 Please give us three weeks to fulfill your request. If items are needed in less time, fill the form out, submit it and contact your affiliate's consultant. Event Ship-to name * Address * Phone number * Email address * Name tags Table-top A's Pom-poms (red only — one per table-top A) Autographed memorabilia (Signature events only — football or basketball when available.) Basketball and football tickets (Signature events only — when available) List a description of the raffle prizes below. For clothing items, please list sizes. (These items are paid for by the chapter.)