Donor Information
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(only enter if gift is from an organization)
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Your Donation
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$
Enter the amount you wish to donate in USD. Example: 50.00
Tribute Gift Information

The Foundation will send notification of your gift to the honoree or family member if you complete the following information.  The gift amount will not be mentioned.

(First and Last)
Other Information
Recurring Authorization
By checking this box, I am allowing the Foundation for LPS to charge my credit card quarterly. A credit card validation will occur immediately where a pending amount will be deducted and then immediately refunded back into my bank account. My first donation will be deducted by 2:30 a.m. following online confirmation. To increase or cancel this recurring donation I will need to contact the Foundation for LPS in writing.
By checking this box, I am allowing the Foundation for LPS to charge my credit card monthly. A credit card validation will occur immediately where a pending amount will be deducted and then immediately refunded back into my bank account. My first donation will be deducted by 2:30 a.m. following online confirmation. To increase or cancel this recurring donation I will need to contact the Foundation for LPS in writing.

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Visa MasterCard American Express Discover
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? Visa®, Mastercard®, and Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.
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Make this a monthly payment?