Donation Form 4-07

(323)221-9111 PHONE DATE:_________________

DON AT IO N FORM Please complete and mail this form in the enclosed envelope or fax to (323) 221-3082. If you have checked pickup/delivery, we will contact you to arrange a convenient time. Ye s, we would like to donate to the Los A ngeles Bo ys & Girls Club. We will donate: ________________________________________ Description – Model

Qt y.

Value

Acknowledgement should be listed as: We will mail/ship this item to you. Please call me to arrange pickup/delivery. We would like to purchase tickets to this event. Please call. Contact Person: ______________________________________________ Name of Business:______________________________________________ Address:

______________________________________________

City, State, Zip:

______________________________________________

Phone Number:

______________________________________________

Fax Number:

______________________________________________

Tha nk y ou f or y ou r do nati on All d on atio ns ar e ta x de ductib le , Ta x I .D. # 2 3-7 304197

Best Time to Call: ______________________________________________

Tha nk y ou f or y ou r do nati on All d on atio ns ar e ta x de ductib le , Ta x I .D. # 2 3-7 304197