TLC SunThe Light Center Donation Form

Please print and fill out this form for donations. Make checks payable to: Light Center Foundation and mail to: Light Center Foundation, Inc. 17421 Marengo Road Union, IL 60180

Mail in Donation Form
Name  
Street Address  
City  
State  
Zip  
e-mail  
Day Phone  
Evening Phone  
Please select donation amount below:

$20 - $50 $100 - $500 - $1,000 - $3,000 - $10,000 - $15,000

Payment:
Please Select Credit Card:
Name on Card:  
Credit Card Number:  
Expiration Date: (mm/yy)