| In Honor of
____________________________________________________________
OR
In Memory of
___________________________________________________________
Number of Luminarias to be made:
__________________________________________
_____________________________________________________________________
Donor Name (Optional)
_____________________________________________________________________
Street Address
_____________________________________________________________________
City
State
Zip
For Participant's Use
Only: (Please fill out in case of questions)
Participant's
Name:______________________________________________________
Phone Number:
________________________________________________________
Team Name:
__________________________________________________________
Team Captain's Name:
__________________________________________________
Total Donation Amount:
__________________________________________________ |
