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Silent Auction Donation Form

14th Annual Gala Saturday, November 5, 2011 Proceeds will benefit the Scleroderma Foundation providing patient support, community education and research (Fed Tax ID# 77-0229244) Company Name: Contact Name: Address: Phone:

Fax:

E-mail:

Item: Description:

Value: Please fax completed form to Scleroderma Foundation/SCC at (310) 287 0795 Items can be sent to: Scleroderma Foundation 10319 Jefferson Blvd. Culver City, CA. 90302 Feel free to enclose any brochures or props for signage and display

If you have any questions, please call (310) 287 0793.

We are extremely grateful for your kindness and support. Thank you.

Silent Auction Donation form  

Silent Aucton donation form for Scleroderma Foundation, Southern California Chapter

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