Sunday, October 7, 2007 eveningwiththestars.com
7-10 pm
The Ivar, Hollywood, CA
No cameras permitted - photo opportunities will be provided
Cocktail Attire
Please print and complete this application and your payment to:
Desi Geestman Foundation
"Touching the lives of children with cancer"
3131 Foothill Blvd. Suite L
La Crescenta, CA 91214
818-249-1105 or fax to 818-249-1003
The Desi Geestman Foundation is a non-profit 501(c)3 organization # 95-4728343.
For further information please call the foundation offices at 818-249-1105.
How did you hear about this event? __________________________________________
Please consult you tax advisor for tax benefits.

We wish to purchase _____ tickets at $75/person $ ________ I/we wish to be a __________________________ sponsor $ ________ I/We will be unable to attend, but would like to make a donation $ ________ Name: _________________________________________________ Address: ________________________________________________ City: ________________________ State: ____ Zip: _____________ Telephone: ___________________ E-mail: _____________________ Check, VISA, MasterCard and American Express accepted (circle one) ____________________________________ ______________________ Credit Card # Expiration Date Please return this card with payment or fax, make checks payable to: The Desi Geestman Foundation 3131 Foothill Boulevard, Suite L La Crescenta CA 91214 818.249.1105 fax 818.249.1003 www.desigeestmanfoundation.org Kindly respond by October 1, 2007 Please consult your tax advisor for tax benefits Tax ID 95-4728343 |