Center for Literacy and Learning

DONOR INFORMATION

Prefix: First Name: Middle Name: Last Name: Suffix: Spouse/Partner Full Name Company: Title: Address: City: State: Zip: - Email: Phone:

GIFT INFORMATION

Suggested Donation Amounts:

$10

Other Amount:

$50

$120

$250

$500

$1,000

Other Amount:

This is a one time donation

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TRIBUTE INFORMATION

Tribute Type: Tribute Name: Acknowledge To: Address: City: State/Province: Zip Code: -

MATCHING GIFT

If your company is eligible, request a matching gift form from your employer, and send it completed and signed with your gift. We will do the rest. The impact of your gift may be doubled or possibly tripled! Some companies match gifts made by retirees and/or spouses.

Our legal name with the IRS is Louisiana Children's Research Center for Development and Learning (EIN 72-1221356).

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