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CARRY 8306 Wilshire Boulevard, Suite 1806 Beverly Hills, CA 90211 www.foratriskyouth.org Phone: (323) 302-0412
I would like to donate:	$ 25.00 $ 50.00 $ 100.00 $ 500.00 Other:
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I will fulfill my donation the following way:	Credit Card - AmEx, Visa, or Mastercard CARRY will contact you to complete your donation Check - Print and mail this form along with your check to the address below
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All gifts are tax-deductible to the fullest extent of the law. Federal Tax I.D.: 14-1946384
Refund Policy for Online Donations Due to the nature of IRS laws, tax exemptions, and associated liabilities there is a no refund policy on donations.

"Shall We Dance?"
Our 6^th Annual Benefit Gala
December 3^rd, 2011
The Beverly Hilton Hotel

TO BUY GALA TICKETS
or

Individual GALA tickets
are
$295
For Tables
or
Group purchases,
please call us at
(323) 302-0412