BOX ART AUCTION

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9th Annual BOX ART AUCTION TO BENEFIT EAST END HOPICE

[ ] $60 per person [ ] $150 Friend (includes 2 tickets)

[ ] $300 Angel (includes 4 tickets) [ ] $500 Donor (includes 6 tickets)

I/We are unable to attend, but wish to send a fully deductible donation of $

Name

Mailing Address

phone email

No. of tickets         Amount Enclosed $

Make check payable to: EAST END HOSPICE

Charge: [ ] Mastercard [ ] Visa [ ] American Express

Account No.                                                          Exp. Date                        CVV

Billing Address

Cardholder's Signature

Please reserve early. Limited seating available. Tickets will be held at the door.

For further information call 631.288.7080 or www.eeh.org

Please note $40 per ticket is non-deductible.