HOLIDAY GIVING DONATION FORM

Please accept my holiday gift of:

    $10 Secret Santa!  ____   $25   ____  $50  ____   $100  ____   Other $______

Donor Name: ___________________________________________________________

Mailing Address: ________________________________________________________

Email: _________________________________________________________________

My gift is in honor of: _____________________________________________________

Mailing Address: _________________________________________________________

Email: __________________________________________________________________

Mail the gift card to ____ me ____ directly to the honoree.

Please mail this form and your check to:

Body Electric

PO Box 591

Santa Barbara, CA 93102