In Memory of or In Honor of

Please fill out the form below and we will send a letter to the recipient letting them know about the gift you made on behalf of the honoree.

*	Question – Required – Your Name
*	Question – Required – Your Email:
*	Question – Required – Type of Request — Select Option
*	Question – Required – Name
*	Question – Required – Is the person deceased?
*	Question – Required – Recipient name:
*	Question – Required – Recipient Address:
*	Question – Required – City, State & Zip Code:
	Question – Not Required – Contact Number:
	Question – Not Required – Please let us know if you’d like a personal note included: