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IT'S TIME FOR DEEDS NOT WORDS... MAX ROACH
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Name: ________________________________________________________________________________ Title: _________________________________________________________________________________ Company: _____________________________________________________________________________ Address: ______________________________________________________________________________ City: ______________________________________ State: ___________ Zip: _____________________ Daytime Phone: (_____) _______________ Fax: (_____) _______________ E-mail: ________________ □ YES, I/We are pleased to serve as a Donor at the level indicated below: Please record my (our) name(s) in the program as follows: ______________________________________ Name(s) exactly as you wish it (them) to appear □ GOLD LEVEL – ($1,000) Event DONOR. Includes 4 tickets, VIP AFTER PARTY, acknowledgment in program, VALET PARKING □ SILVER LEVEL – ($500) Event DONOR. Includes 2 tickets, VIP AFTER PARTY, acknowledgment in program, VALET PARKING □ BRONZE LEVEL – ($250) Event DONOR. Includes 1 ticket, VIP AFTER PARTY, acknowledgment in program, VALET PARKING □ Make check payable to: MUSICaids...life thru music 7985 Santa Monica Blvd. #419 West Hollywood, CA 90046 □ I/We are unable to attend, but enclosed a contribution of $ ________________________
The MUSICaids...life thru music is a 501(c)(3) tax-exempt organization. Your contribution is tax deductible to the fullest extent of the law. Our Federal Tax Identification number is 02-0696603. For more information contact 213 590-0844 or e-mail: musicaidsmusic@sbcglobal.net PRINT PAGE AND MAIL TO:
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