Memorial Gift Form

In Memory Of

First Name: *

Last Name: *

Address:

Address 2:

City:

State:

Postal Code:

Country:

Please notify the following person(s) of this memorial gift:

yes

no

Donor Information

Person 1

First Name: *

Last Name: *

Address:

Address 2:

City:

State:

Postal Code:

Country:

Phone: *

Email Address: *

Person 2

First Name:

Last Name:

Address:

Address 2:

City:

State:

Postal Code:

Country:

Phone:

Email Address:

Ways to Give

Tribute Gift

Many donors choose to contribute by offering an honorarium gift to celebrate a birth, marriage, anniversary, graduation or other "special" event in their lives. These gifts are in the form of cash, check or credit card authorization.

Please make checks payable to:
Lazarus House Ministries
P.O. Box 408, Lawrence, MA 01842
or donate online on the Tribute Gift page.