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Planned Parenthood Southeastern Pennsylvania

Chester County and Main Line Autumn Community Gathering
October 12, 2011 - 12:00 p.m. – 2:00 p.m.
Villanova, PA

Location to be disclosed to paid ticket-holders only. For additional information, please contact our offices at 215-351-5534 or autumngathering@ppsp.org.

Please select your donation from the list below.

* = Required Fields

Item	Quantity	Price	Description
$1000 Benefactor (4 Reservations)			• Invitations to Private Reception plus photograph with Dr. Ruth (11:00 am) • Benefactor listing in the program book and 2012 annual report • $550 is tax deductible.

First Name
Last Name
Address
Address 2
City
State
Zip
Phone
Email
How did you hear about the Chester County Autumn Community Gathering?
Guests’ Names (please separate using a comma)

I will use tickets, please donate the remainder to volunteers and staff who cannot afford the price of a ticket.