donation form

Online Donation Form

(Print out, complete and mail)

Name: ____________________________

Address: __________________________

City: _______________ State: ___ Zip: _____

Phone (including area code): _________________

Gift of: ____ $35     ____ $50

             ____$100    ____ Other $ ________

___ I am willing to make a monthly pledge of:

___ $10  ___ $25  ___ $35  ___ Other $ ______

___ I wish for my gift to remain anonymous.

Please send me information on:

___ The League’s programs & services

___ Including the League in my will or estate

___ Referring someone to the League for service

___ Volunteer opportunities

 

 

Checks should be made payable to:

The League for the Blind & Disabled

Please mail to:

5821 S. Anthony Blvd.

Fort Wayne, IN 46816

 

Your gifts are tax-deductible!