For more information
please call:

212.629.2099
or
Toll Free
1.888.347.KIDS (5437)


or e-mail us



 
 
Follow Us:
FacebookFollow Us: Youtube
 


PRINT OUT GIFT FORM

Donor Information

Please fill out the following. (An * indicates a required field.)

*Title:
* Last Name:
* First Name:
* Company:
* Company Address:
* City, State, Zip Code:
* Country:
* Home Address:
* City, State, Zip Code:
* Country:
* Day Phone & Area Code:
* Evening Phone & Area    Code:
    Fax #:
    E-mail Address:

Please do not add me to your email list (except for an email acknowledgment).

Please do not add me to your regular mailing list.

Would you like this donation to be made in honor or in memory of someone? If so,      check this box. You will be asked for the honoree's name after the next step.

Please check here if you would like more information on how you can help support      Love Our Children USA™ via your will or a gift that will provide life income to you,      like a charitable gift annuity.


Honorary or Memorial Donation


Please fill out the following. (An * indicates a required field.)
* This gift is given In Honor Of In Memory Of and will be acknowledged to:

* Title:
* Name:
* Address:
* City, State, Zip Code:
* Country:
 
Personal Message:

Donation and Credit Card Information:

Please fill out the following.
(An * indicates a required field.)
* Donation: $

MasterCard Visa Discover AMEX (AMEX accepted only over $1,000)

* Credit Card Number:
* Expiration Date:
* Name (as on card):
* Address where card is    billed:
* City, State, Zip Code:
* Country:

Email us with your name, address, credit card type (Visa, MasterCard, Discover, or for donations over $1,000 American Express is accepted), its number, the expiration date, the name listed on the credit card, the amount of your donation and a daytime and evening telephone number.

 

© All rights reserved. Love Our Children USA™ 1999 - 2017

 





Sitemap

Web Design Albany by Leapfrog Marketing