CPHI Community Partnership For The Homeless - Aid to Homeless citizens of South Florida

Community Partnership for Homeless Next Generation Council

Invites you to break dance, rock out and walk like an Egyptian at:

FLASHDANCE
THE AFTER PARTY

Get into the groove and enjoy complimentary desserts and open bar.

Friday, November 3, 2006
10:00 PM – 1:00 AM
JW Marriot
1109 Brickell Ave, Miami, FL

Tickets are $50 per person and $60 at the door

Please provide the following information:

Party Sign-up Form

* indicates required fields

Business Name:

(If none, leave blank)

First Name:

* (as it appears on your credit card)

Last Name:

* (as it appears on your credit card)

Street Address:

City:

State:

Zip Code:

Country:

Phone Number:

Fax Number:

Email Address:

Card Type

Credit Card Number:

Expiration Date:

/ *

Donation Amount:

*	Please put numbers only (no $ sign)

Customer credit cards will be billed as CPHI.