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Gift Information

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$
Donation Frequency*

If you would like to make a Memorial Donation, please contact our office at 800-958-7876 or at info@lfaheartland.org. 

Contact Information

Prefix
First Name*
Middle Name
Last Name*
Individual/Corporate Gift
Company/Organization Name
Country*
Address*
City*
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Email*
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Phone*

Matching Gifts

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Matching Gift Qualified

If you work for a company that offers matching gifts, please remember to check with your Human Resources department for the appropriate matching gift form and submission process.

 
 
 

Payment Information

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Card Number*
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