Share The Light

The following fields are required before we can process your registration:

• Name
• Email
• Address
• City
• State
• Zip Code
• Home Phone
• Account Number

Select your pledge frequency and indicate the amount of your gift for each area that you would like to support.

Area		Frequency				Amount
Public Art		Monthly Pledge One Time Donation				$1 $5 $10 Other Other Amount $
Community Beautification		Monthly Pledge One Time Donation				$1 $5 $10 Other Other Amount $
Youth Recreation Scholarships		Monthly Pledge One Time Donation				$1 $5 $10 Other Other Amount $
Public Health		Monthly Pledge One Time Donation				$1 $5 $10 Other Other Amount $
Fire Prevention		Monthly Pledge One Time Donation				$1 $5 $10 Other Other Amount $
Crime Prevention		Monthly Pledge One Time Donation				$1 $5 $10 Other Other Amount $

Name
Email:
Address:
City:
State:
Zip:
Home Phone:	(xxx)xxx-xxxx
Work Phone:	(xxx)xxx-xxxx
Account #:
I do NOT wish to be included in any public recognition of Share The Light Contributors.

 

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