Thank you for donating to DIFFA DINING BY DESIGN Please provide us with the following information so that we may proper by gjl50468

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									                          Thank you for donating to DIFFA DINING BY DESIGN.
                          Please provide us with the following information so that we may
                          properly recognize your gift.
                          All donations benefit our Excellence in Care Awards
                          All items to be delivered or mailed by October 27th to: DIFFA
                          Chicago, 222 Merchandise Mart, Suite 939, Chicago, IL 60654


                          DIFFA/Chicago 222 Merchandise Mart, Suite 939 Chicago, IL 60654
Items Name – Brief Description (please be as detailed as possible, this is used to describe each item in the
program and bid sheets)




Donor Name (please print)                                    Signature



Company Name                                                 Date



Address (city, state, zip code)



Email Address                                                Phone



Estimated Value of Item                                      Minimum Bid (if applicable)


A letter of acknowledgment for your tax records will be sent after the event. DIFFA/Chicago is
a 501(c)3 not-for-profit organization.

Please complete this form and return it to the DIFFA Chicago office via
fax 312-644-6413 or email info@diffachicago.org
Any questions? Contact Karen Hyland at the DIFFA Chicago 312-644-6412.

Thank you for your support!

								
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