Item Donor Form
Please fax this to SafePath Children's Advocacy Center, Inc. at 770.801.3468
by April 1,2007*

Name:___________________________________________________________

Telephone:__________________ Email:________________________________

Company:________________________________________________________

Address:__________________________________________________________

City:____________________________ State:___________ Zip:_____________

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________ Yes, I would like to donate an auction item for the 6th Annual Hearing Children's Voices Benefit Auction for SafePath.

Specifically, I am donating______________________________

Valued At:___________________________________________


   ________ *I am interested in donating an auction item, however my company's approval process may take longer than April 1,2007.    

________ No, I cannot donate an auction item at this time, however, enclosed is my donation in the amount of $____________

_________ I would like to purchase ________ ticket(s) to the event. ($125 ea.) Enclosed is my check in the amount of $___________


Please Check One

________ Please contact me to arrange pick up of this item.                                               

________ I will mail the item to Ginger Gilbert at SafePath Children's Advocacy Center, Inc.
    2221 Austell Road, Suite B, Marietta, GA 30008



Should you have any questions, please contact
Ginger Gilbert at 770.801.3469 or funddev@mindspring.com
Thank You.