The Louisiana Academy of Family Physicians Foundation
is asking for your assistance in supporting their 16th Annual Silent
Auction, which will culminate in LAFP's exhibit hall on Saturday,
July 5, 2007, Sandestin Resort, Destin, Florida.
Please complete and return this form to the LAFP Foundation,
919 Tara Blvd., Baton Rouge, Louisiana 70806, by June 1, 2008 (or deliver item to the LAFP Registration Desk by July 3rd), so
that we may prepare the
Bid Sheets. We ask that you use one sheet per donation. If you need
additional information about the Silent Auction or the LAFP Foundation
please contact Jade Verret or Cathy Stanley at 225-923-3313.
Donor:
Contact Person:
Company:
Address:
City:
State:
Zip:
Telephone:
Fax:
Email:
Type of Support
Please check the type of support you will give and supply relevant
information.
General Support-Amount $
In-Kind Support/Gift-Estimated Value $
(Please assign the value of your item as it may be tax deductible.
You will receive a receipt for the amount indicated on the form.)
Give brief description of item donated:
Item Donated:
Item Description:
Restrictions: