Lainie's Angels Donation Form

We appreciate your support of Lainie's Angels. Your donation will help to provide an angel for families in need. Please fill out this page and mail or fax it, along with your check or credit card information, to the address and number below. Or, you can always call us at any time. Name:________________________________________________________________________ Address:______________________________________________________________________ City/State/Zip:_________________________________________________________________ Pledge:    ___$25   ___$50   ___$100   ___$250   ___$500   ___$1000   ___Other Credit Card Type:______________________________________________________________ Credit Card Number:____________________________________________________________ Expiration Month:_______________________________     Year:________________________ Signature:_____________________________________________________________________ Email Address:_________________________________________________________________ Gifts in Honor or Memory Description (i.e., in memory, in honor, birthday, etc.):________________________________ Name of Honoree:_________________________________________________________________ Send Announcement to:_____________________________________________________________ Address:___________________________________________________________________________ City/State/Zip:_____________________________________________________________________ If you would like to receive periodic news about Lainie's Angels, please be sure to include your email address above, or provide it when you call. You can also give to Lainie's Angels through The United Way's directed donor giving programs. Our United Way number is 043334. Lainie's Angels is a 501 (c) (3) not for profit charitable foundation. 24 Oak Grove Lane Edison, NJ 08820 Ph 732-906-7887 Fax 732-906-2239 www.lainiesangels.org