Art With Heart Ticket Form

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Domestic Violence

United Family Services
601 East Fifth Street, Suite 400
Charlotte NC 28202
Phone: 704.332.9034
Fax: 704.373.1604 info@ufsclt.org


Art With Heart Ticket Form

Please complete the form below to purchase tickets for the 13th Annual Art With Heart Art Auction, held on Saturday, February 4, 2012 at Founder's Hall.

Visit us online at www.artwithheartauction.com for more information about our event or call (704) 367-2799. Proceeds from this auction benefit United Family Services' including the Shelter for Battered Women.

Number of BidPal Devices (one per couple)

Title

\n" \n" \n" \n"

Dr."

Mr."

Mrs."

Ms."

First Name

Middle Name

Last Name

Spouse Name

Address Type

Company/Organization Name

Address Line

Suite/Apt

City

State

Zip

Phone Number

Email Address

Guest Name(s)

Admission Type

General ($100 per ticket)

Patron ($200/ticket or $375/couple. Includes event ticket(s) with premier seating, raffle ticket(s) and event recognition.

Art Donor

Committee

Number of Tickets

Number of Raffle Tickets ($10 ea)

Payment Method

Credit Card Number (no dashes)

Exp Date

3 Digit Verification Code (back of card)

To help us avoid computer generated inquiries and spam, please enter the letters and numbers exactly as you see them in the box below.

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