fax order form - Chairs for Charity
Transcription
fax order form - Chairs for Charity
Date: Company Name: Account # Phone # FAX# P.O.# Contact Name: Address: Delivery Address (if different from above): City: State: Zip: Street: City: State: Zip: MC OTHER If paying by credit card, please check box: AMEX VISA Expiration Date: Credit Card # Cardholder’s Name (please print): Signature: Would you like a phone call confirming this fax? Item Number Qty Unit YES Description AIM Center, Inc. Alexian Brothers Senior Neighbors American Heart Assoc. American Red Cross, Greater Chattanooga Area Big Brothers/Big Sisters of Greater Chattanooga Walter Boehm Birth Defects Center Boy Scouts of America, Cherokee Area Council Boys & Girls Clubs of Chattanooga Catholic Charities of Chattanooga Chattanooga Goodwill Industries Chattanooga Room in the Inn Chattanooga’s Kids on the Block Children’s Academy for Education & Learning Children’s Home/Chambliss Center Communities in Schools of Catoosa County Council for Alcohol and Drug Abuse (CADAS) Epilepsy Foundation of Southeast Tennessee Family Crisis Center of Walker, Dade, Catoosa & Chattooga Counties Fortwood Center Four Points Gifts In Kind Girl Scouts of Moccasin Bend Council Girls Incorporated of Chattanooga Hospice of Chattanooga Jewish Community Federation of Greater Chattanooga LaFayette Area Empty Stocking Fund Little Miss Mag Day Care Center Maurice Kirby Child Care Center Northside Neighborhood House Ochs Center for Metropolitan Studies Orange Grove Center, Inc. Partnership for Families, Children and Adults Pro Re Bona Day Nurseries Primary Health Care Center of Dade County RE:START - The Center for Adult Education The Salvation Army Signal Centers Special Transit Services Speech & Hearing Center The Team Centers Tri-State Food Pantry United Way of Greater Chattanooga United Way’s Project Ready for School United Way’s 211 Information & Referral Service United Way’s Volunteer Center United Way’s Building Stable Lives Urban League of Greater Chattanooga Volunteer Community School, Inc. Walker County 4-H YMCA Price FAX ORDER FORM I want my Chairs for Charity donation to be made to:* NO *Please circle the name of the organization to which you wish to donate. Look inside to discover how you can support your employees and United Way partner agencies at the same time. GIVE. ADVOCATE. VOLUNTEER.