Program Tribute Form
2012 Annual Scholarship Benefit Honoring _______________________
Name:________________________________________________________
(Please give name exactly as you would like it listed in our printed material.)
Address:______________________________________________________
Contact Number: _______________________________ 
Email: ________________________________________
Program Tribute Description, including size and color, etc. -------
__________________________________________________________
__________________________________________________________
Program Tribute Message __________________________________________________________
_______________________________________________________________________________
Enclosed is check in the amount of $______________ payable to "CVAP Benefit 2012"
Please Mail to: CJ Westrick, 73365 Juniper, Palm Desert, CA 92260
Tribute will be displayed prominently in Benefit Program and on CVAP website.
Please provide camera ready art, logos and color or B/W photos to wesgroup@msn.com
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