Third Annual KH 6515 Wine Donation Form
User Manual: KH 6515
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Wine Donation 15th Annual Touch a Heart Dinner & Auction Friday, November 14, 2014, 7:00 p.m. The Four Seasons Hotel • Miami, Florida Name: Company (if applicable): Address: City: State: Zip: Phone (s): Email: Name for Publication: (EXACTLY how you wish it to appear in print) I prefer to donate anonymously. # of Bottles Bottle Size Vintage Value Bottle Size Vintage Value Bottle Size Vintage Value Wine Description: # of Bottles Wine Description: # of Bottles Wine Description: Donor Signature: Date: For more information, contact Wine co-chairs Kara Zeder (kzeder@gmail.com 305-458-6515), Dana DeMaria Nateman (ddemaria@truckmax.com 305-777-9024 Or at Kristi House, Mary Faraldo (mfaraldo@kristihouse.org 786-218-9748) A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE. THE TOLL-FREE NUMBER IS 1 (800) 435-7352. 1265 Northwest 12th Avenue Miami, FL 33136 Tel 305.547.6800 Fax 305.547.6816 www.kristihouse.org
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