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DONATION FORM - Thank you for your interest in making a donation to Life and Liberty! Your contribution is tax deductible. A receipt acknowledging your donation with the proper tax information will be given at your request. This donation form should be printed out and mailed to us directly with your payment. Please contact us should you have any questions.

Please mail your check or money order along with this form to:
Life and Liberty Inc.
415 Melrose Ave., P.O. Box 201
Ambridge, PA 15003
PLEASE PROVIDE THE FOLLOWING INFORMATION:

PLEASE NOTE: If you would rather make a confidential donation, the following information is not required.

FIRST NAME:        

LAST NAME:          

PHONE NUMBER:   

EMAIL ADDRESS:  

ADDRESS:    

Yes, I want to help Life and Liberty, Inc. make a significant impact on our community working through a unified vision by making a donation. I would like to make a donation of:
 $50    $100    $250    $500    $1000    Other
If other, please specify:

Do you want a receipt mailed back to you for tax purposes? Yes  No

For a printer-friendly version of this form:

If you would rather make a donation via the United Way, please click here to access their website. The United Way contribution number for Life and Liberty is #1378562.
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