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Lebanon County Christian Ministries Benefit Dinner _ Silent

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					                                   Lebanon County Christian Ministries
                                     Benefit Dinner & Silent Auction
                                      Gift Basket Registration Form

                    If donating a basket, please complete this form and send it to
                              LCCM, 250 S. 7th St., Lebanon, PA 17042.

        Completed baskets should be delivered to LCCM no later than August 22, 2011.



Name or Name of Church/Organization:

Address:

City/State/Zip:

Phone:

Title of Basket (Theme):
If you are donating more than one basket,
please list them in the space provided.

				
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posted:8/2/2011
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