Lakeshore Excellence Foundation Donor Form
Mail-In Contributions

Please print this form and send it to:
Lakeshore Excellence Foundation, 5771 Cleveland Avenue, Stevensville, MI 49127

Please Print:

Name: _______________________________________________________

Address: _____________________________________________________

City/State/Zip __________________________________________________

Daytime Phone: __________________________

Evening Phone: __________________________

I am a Lakeshore Graduate(Circle One): Yes / No

If Yes What Year?________

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Please check the amount of your donation :
(Gifts to the Lakeshore Excellence Foundation are tax-deductable.)

My employer will match this gift (Circle One): Yes / No

Public acknowledgement of this gift should be made in the name of:

Name:_______________________________________________________

Address:_____________________________________________________

City/State/Zip: _________________________________________________

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Please make checks payable to: Lakeshore Excellence Foundation