Fundraiser Information Request

Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Home Phone
FAX
E-mail
URL

I am interested in the following fundraising programs:
(Check all that apply)

10 Oz. Jar Candles Only
Multi-product Brochure
Perfect Mixes (Soup, Dip & Cookies)

I would like to be contacted by:

Phone
Fax
Email
Postal Mail

Best time to call:


Questions or Comments:


Copyright © 2004 [Kent & Jackie Shappart, Gold Designers]. All rights reserved.
Revised: 10/11/04
Note: Your privacy is important to me, and your information will never be sold or given to anyone else.