Become an LTCF Home Sponsor

YES, I want to become a part of the team of monthly LTCF HOME SPONSORS!

MONTHLY COMMITMENT

My monthly commitment is:

Amount:

Other Amount, pls. specify:

MONTHLY PAYMENT PLAN

Your monthly donation large or small will make a difference.
All gifts are tax deductible.

I would like to pay my monthly commitment in the following way:

        Option #1   CHECK
                        I will send you a check monthly
                    Check by Phone / Fax:
                                   If you fax or email us a copy of your check or call our office with your check
                                   information, we are able to process it through a service called Check By Phone.
                                  (With this payment plan you will NOT need to send us your check in the mail.)

Option #2 CREDIT CARD/DEBIT CARD

Online Donation

Would you like your donation automatically billed on your
credit/debit card monthly? Yes No

PERSONAL INFORMATION

Name of Sender:

Address:
(Street No., Street Name, City, State, Zip Code)

Telephone:

FAX No.:

E-mail:

NETWORK INFORMATION

I would like to receive:

Email updates Postal mailings

Thank you for taking the time in filling up the response form.

Please review all the entries before submission.

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