Thank you for choosing to make a difference by giving to the
The Center for Violence Free Relationships !

PLEASE PRINT THIS FORM, FILL OUT AND MAIL TO:
344 Placerville Drive, Suite 11, Placerville CA 95667

Community donations are extremely important in enabling us to carry out our mission to build healthy relationships, families and communities free from sexual assault and domestic violence through education, advocacy and services in western El Dorado County .

Please accept my donation of $_____________
I choose to be an active donor. Please send me a supply of remittance envelopes.
We want to keep our donation anonymous. Please accept my donation of $_________________ and do not include my name on your mailing list for future mailings.

Name Phone Number
____________________________________________ ____________________________________________
Address Email Address
_______________________________________
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_______________________________________		 ____________________________________________
Check Enclosed $__________
MC/VISA/Amer.Exp. # _______________________________________ Amount $ _________
Signature __________________________________________ Expiration Date ________

Please make my donation:

In honor of ____________________________________________________________

In memory of ____________________________________________________________

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Our annual auction has been a cornerstone of our fund raising efforts for over 21 years and is well known in the community as an outstanding event with delicious food, wine and great company. Artists and Businesses from the community donate some of the finest art and products and services for your bidding.

Please send me more information on your annual auction.
I'd like to receive your Quarterly Newsletter.

Mail form to: