In Memory/Honor of

In Memory/Honor of - Form

Thank you for your generosity.
Your Name*

First NameLast Name
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Phone Number*

Area CodePhone Number
Would you like your donation*

In Honor of (used for living loved ones)In Memory of (used for deceased loved ones)
Name of person*

First NameLast Name
Would you like a card of acknowledgement sent to family/individual

YesNo
Family or individual
ie: Travis & Amy Steele, The Steele Family etc.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Amount of donation*
Would you like us to tell them this donation was given by you in their memory/honor?

YesNo
Please mail donations to Lily's Hope Ministry or donate online: www.lilyshopeministry.com
Lily's Hope Ministry

c/o Travis/Amy Steele

1750 67th Ave NE

New Rockford, ND 58356
Please make checks payable to: Lily's Hope Ministry
Comments:
Should be Empty:

In Memory/Honor of - Form