University of North Carolina at Chapel Hill Athletics
University of North Carolina at Chapel Hill Athletics Memorabilia Request Form MEN’S BASKETBALL AUTOGRAPH FORM #1 2017-18 AUTOGRAPHED TEAM BALL Provisions of UNC Department of Athletics’ merchandise, property, and resources to other organizations or individuals are governed by numerous NCAA, ACC, UNC, and State of North Carolina rules and procedures. All requests must be submitted on this form. Incomplete forms will be returned to sender. All items are available only while supplies last. Walk-in purchases are not allowed and all forms must be mailed to the address below. CHECK ONE 1 BALL – $200
2 BALLS – $400
3 BALLS – $600
Check#_________________
Requestor Information (Shipping Address): Last Name:
First Name:
Street Address:
City:
Telephone Number:
State:
Zip Code:
Email Address:
Purpose of Request (check applicable box): Self, personal memorabilia Self, gift to individual Organization
If “Self,” continue to Statement of Understanding. If “Organization”, read and complete the following:
Organization Name:
Telephone Number:
Street Address:
City:
State:
Zip Code:
Date of Event:
Organization Classification (check applicable box): Elementary School (Grades K – 6) Junior/High School (Grades 7 – 12)/Preparatory School/Junior College Non-Profit/Charitable Organization Other, please describe: Will the item be sold or auctioned for fundraising purposes? Yes No If so, will prospect-aged (Grades 7 – 12, prep school, junior college) students benefit from the sale?
Yes
No
PLEASE NOTE THAT NCAA RULES PRECLUDE US FROM PROVIDING ITEMS TO FUNDRAISERS THAT WILL BENEFIT PROSPECT-AGED INDIVIDUALS. Unfortunately, requests from such groups must be returned to sender. What organization will receive the proceeds from the sale?: REQUESTS FROM NON-PROFIT ORGANIZATIONS MUST BE ACCOMPANIED BY DOCUMENTATION OF ITS 501(c)(3) STATUS (e.g., a copy of the organization’s IRS letter verifying this status or the organization’s tax identification number) AND DOCUMENTATION DESCRIBING THE FUNDRAISING EVENT IN WHICH THE ITEM WILL BE USED (e.g., flyer for event, memo describing event).
Statement of Understanding: By my signature below, I certify that the item provided to me per this request will be used only in the manner I specify above. I understand that this item may not be sold for personal profit nor donated to a fundraising activity unless designated as such above. If I am giving this item as a gift, I certify that I will notify the recipient of the applicable regulations. Lastly, I understand that this item may not, under any circumstance, be re-sold or auctioned through the internet (e.g., eBay, etc.). Requestor’s Signature:
Date:
Mail completed form and check or money order made payable to “Autographed Basketballs for Community Service (or ABCS)” to: ABCS/UNC Men’s Basketball Office, 300 Skipper Bowles Drive, Chapel Hill, NC 27514. If we are sold out, your check will be returned. Please do not call to check on the status of your order.
For Office Use Only: Compliance Approval: Request Forwarded to
Granted
Denied Office
Staff Member Initials Date:
2 BALLS – $400
3 BALLS – $600
Check#_________________
Requestor Information (Shipping Address): Last Name:
First Name:
Street Address:
City:
Telephone Number:
State:
Zip Code:
Email Address:
Purpose of Request (check applicable box): Self, personal memorabilia Self, gift to individual Organization
If “Self,” continue to Statement of Understanding. If “Organization”, read and complete the following:
Organization Name:
Telephone Number:
Street Address:
City:
State:
Zip Code:
Date of Event:
Organization Classification (check applicable box): Elementary School (Grades K – 6) Junior/High School (Grades 7 – 12)/Preparatory School/Junior College Non-Profit/Charitable Organization Other, please describe: Will the item be sold or auctioned for fundraising purposes? Yes No If so, will prospect-aged (Grades 7 – 12, prep school, junior college) students benefit from the sale?
Yes
No
PLEASE NOTE THAT NCAA RULES PRECLUDE US FROM PROVIDING ITEMS TO FUNDRAISERS THAT WILL BENEFIT PROSPECT-AGED INDIVIDUALS. Unfortunately, requests from such groups must be returned to sender. What organization will receive the proceeds from the sale?: REQUESTS FROM NON-PROFIT ORGANIZATIONS MUST BE ACCOMPANIED BY DOCUMENTATION OF ITS 501(c)(3) STATUS (e.g., a copy of the organization’s IRS letter verifying this status or the organization’s tax identification number) AND DOCUMENTATION DESCRIBING THE FUNDRAISING EVENT IN WHICH THE ITEM WILL BE USED (e.g., flyer for event, memo describing event).
Statement of Understanding: By my signature below, I certify that the item provided to me per this request will be used only in the manner I specify above. I understand that this item may not be sold for personal profit nor donated to a fundraising activity unless designated as such above. If I am giving this item as a gift, I certify that I will notify the recipient of the applicable regulations. Lastly, I understand that this item may not, under any circumstance, be re-sold or auctioned through the internet (e.g., eBay, etc.). Requestor’s Signature:
Date:
Mail completed form and check or money order made payable to “Autographed Basketballs for Community Service (or ABCS)” to: ABCS/UNC Men’s Basketball Office, 300 Skipper Bowles Drive, Chapel Hill, NC 27514. If we are sold out, your check will be returned. Please do not call to check on the status of your order.
For Office Use Only: Compliance Approval: Request Forwarded to
Granted
Denied Office
Staff Member Initials Date:
