Download agreement to donate - Cancer Association of Greater New Orleans

RE: Cancer Association of Greater New Orleans (CAGNO) – Viva La Cure
Saturday, August 20, 2016 7:30-11:00pm
Hampton Inn & Suites-Convention Center (1201 Convention Center Blvd New Orleans, LA 70130)
Dear Friend of CAGNO:
I am writing you on behalf of the Cancer Association of Greater New Orleans, for your support of the 3rd
annual Viva La Cure – A Night of Hope to be held on Saturday, August 20, 2016 at the Hampton Inn &
Suites-Convention Center Riverside Ballroom. As a coordinator of this event, I will be assisting with
securing sponsorships and donations; and I hope you will donate a signature item.
This unique event is sure to become a premier social event with patrons from the medical community
as well as local supporters of CAGNO. Proceeds from the event will benefit the Cancer Association of
Greater New Orleans. CAGNO assists local cancer patients in the greater New Orleans area and 13
surrounding parishes to ensure continuity of care while undergoing cancer treatment. CAGNO assists
patients to obtain desperately needed medications and nutritional supplements, along with other
necessities, that can prove to be very costly. CAGNO is the only cancer agency that provides direct
financial support to local cancer patients.
Please consider supporting the very important work of the Cancer Association of Greater New Orleans
by donating an item or a gift certificate to be featured in this fundraiser. With your contribution, even
more of our neighbors can receive help from CAGNO.
Should you decide to participate, enclosed is a form for you to complete and return. Your donation to
the Cancer Association of Greater New Orleans is the best way to ensure uninterrupted cancer care
treatment for friends in our community.
Sincerely,
Viva La Cure – A Night of Hope Coordinators
Benefiting:
CAGNO is a 501 ( c ) (3) non-profit organization. EIN Number: 72-0517802
AGREEMENT TO DONATE
Viva La Cure- A Night of Hope
Saturday, August 20, 2016
Hampton Inn & Suites New Orleans Convention Center
Please return completed form to the Cancer Association of Greater New Orleans
Attn: Paula Gros, Patient Services Director, phone: 504.733-5539 email: [email protected] fax: 504.733-0252
824 Elmwood Park Blvd Suite 154 New Orleans, La 70123
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Name of Donor _____________________________________________________________
Contact Name_________________________________________________________________
Address __________________________ City____________ Zip_________________________
(All correspondence will go to this address)
Phone______________ Fax________________ E-Mail_________________________________
Hereby Agrees to Donate
Item Description
Please provide a detailed description of the donation.
Available Dates of Use (if applicable)_______________________________________________
Restrictions (if applicable)________________________________________________________
Fair Market Value (Retail Value) of $___________
Delivery (check):
Donor to deliver to CAGNO office on or by_______________________.
DATE
Item/Certificate to be picked up on or after _______________________.
DATE
DONOR AUTHORIZED SIGNATURE
TITLE
DATE
CAGNO is recognized as an organization exempt from Federal Income Tax under section
501(c) (3) of the Internal Revenue Code
EIN Number: 72-0517802