Lights of Love Donation Form

Lights of Love Donation Form

I WISH TO GIVE A LIGHT.

(When giving more than one Light, please fill out separate forms for each.)

In Honor of

In Memory of

NAME (As it should appear in Book of Remembrance)

GIVEN BY (Name as it should appear in Book of Remembrance)

Email

PLEASE ACKNOWLEDGE THIS DONATION TO:

Name

Name

First

First

Last

Last

Address

City

State

Zip Code

THIS ACKNOWLEDGMENT CARD SHOULD BE SIGNED:

Wording for Donor's Signature Line

Donor Name

Donor Name

First

First

Last

Last

Address

City

State

Zip Code

If you are human, leave this field blank.