A Christmas To Cure Cancer Donation Form

Directions:
  1. Provide the address you wish to have your tickets mailed to.
  2. Choose your tickets.
  3. If paying by check, make checks payable to "A Christmas To Cure Cancer".
  4. Mail your order to:
    A Christmas To Cure Cancer
    5226 Columbine Ct.
    Columbus, OH 43230
Name: ____________________________________________________________
Address 1: ____________________________________________________________
Address 2: ____________________________________________________________
City: __________________________ State: ______ Zip: _____________
Phone: __________________________ E-Mail: __________________________

Item Description Donation Quantity Total

Tickets for the Dinner at the Columbus, Ohio Benefit
Guest Speaker Heather Pick.
Friday, November 30, 2007 at 6:00 PM.

Crown Plaza Hotel
600  Metro Place North
Dublin, OH 43017
(614) 764-2200


 $100.00    

Tickets for the Columbus, Ohio Benefit
November 30, 2007

Crown Plaza Hotel
600  Metro Place North
Dublin, OH 43017
(614) 764-2200

Doors open at 7:30 PM
Music starts at 8:30 PM

 $25.00    
 
  Grand Total: $ ______________



Thank you for your donation!