Bidder Registration Form
(All sales final)

For office use only.

Registration #:_____________


Internet/Silent bidding will begin on November 1, 2007. After receiving this form, Gallery Jamel will then contact you by telephone to obtain credit card information and will issue to you a Registration ID which will be used when you submit a bid. From November 1 to December 5 at 11:00 pm EST, you may place bids on-line for the Internet/Silent Auction after obtaining your Registration ID. This form should also be used to register for absentee bids in the Live Auction on December 7, 2007.
I have read and agree to the Terms & Conditions, and I agree that my bid is a contract between myself and Gallery Jamel:(You must check this box.)
Last Name:
First Name:
Address:
 
City:
State/ Providence/Region:
Zip: -
Country:
Preferred Phone #:
Alternate Phone #:
E-mail Address:
Re-enter e-mail Address:
Credit Card Info (if desired): 

VISA  MasterCard
American Express
Number:
Expiration Date:
Due to security concerns, Gallery Jamel will contact you regarding the 3-digit security code on the back of your card.
Signature:

The following would be helpful for our organizational purposes:
I intend to participate in the Internet/Silent auction . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   I will be an absentee bidder during the Live Auction on Dec. 7 . . . . . . . . . . . . . . . . . . .
I am planning on attending the Live Auction on Dec. 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
 
 		   I wish to purchase one or more of the Paintings For Sale, but will be unable to attend the event on Dec. 7 . . . . . . . . . . . . .

Print this form (set top & bottom margin to zero to fit on one page), fill it out and mail to: Gallery Jamel, 12102 Old Line Centre, Waldorf, MD 20602 or fax to Gallery Jamel at 301-932-5596


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