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Planned Parenthood Southeastern Pennsylvania’s
The Choice Event
21st Annual Fall Event and Auction

Saturday, November 7th 2009
6:30 – 10:00PM
Philadelphia, PA

Location disclosed only to paid ticket-holders via return e-mail upon registration. For additional information, please call 215-351-5552 or debra.loggia@ppsp.org

EVENT SUBSCRIBER LEVELS

* = Required Fields

Item	Quantity	Price	Description
Donation			I/We cannot attend, but enclose a $_______ gift to support PPSP’s programs and services.

First Name
Last Name
Address
City
State
Zip
Phone
Email
How did you hear about The Choice Event?
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.