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Lithuanian Mercy Lift
Donation
With so many worthy
Lithuanian causes to support, we are grateful
for your generosity. As an all volunteer
organization, we hold operating costs to the
minimum to put your contributions to work
helping to improve health care in Lithuania.
YES, I’d like to help Lithuanian Mercy Lift
continue its work.
Name
__________________________________________________________
Address
__________________________________________________________
City
____________________________________
State/Region ________________
Zip/Code____________ Country
___________Email
___________________________
Donation: o$15 o$25
o$35 o$50 o$100 o$200
o$_________________
Please designate donation to
program: _____Breast Cancer/Mammography
_____Diabetes Support
_____Facility Renovations and
Improvements
_____HIV/AIDS
Prevention _____Ona
Kutkaite-Durbin Fund for Jurbarkas Hospital
_____Perinatal & Child
Care _____TB Prevention and
Control
_____Youth Suicide
Prevention _____ Wherever
most needed
_____ Other
__________________________________________________________________
If you prefer, print form and
send check payable to:
Lithuanian Mercy Lift
PO Box 88,
Palos Heights, IL 60463.
Please inquire if your employer
participates in a Matching Gift Program.
Donations are tax deductible to the extent the
law allows. LML is a not for profit charitable
organization under section 501(c){3) of the
Internal Revenue Code. Federal Tax ID #
36-3810893.
Thank you for your
generosity! |
