CONCORDIA LUTHERAN CHURCH

Concordia Lutheran Church

Donation Form

Donation Amount:

$________

Donation (circle one) in Memory in Honor

of ___________________________________________________________

Donation Given By

Your Name: __________________________________________

Address: __________________________________________

__________________________________________

Your tax deductible donation will be acknowledged in the next issue of the "Concordia News."

If you would like us to send notification of your gift to a family member or other interested person, please provide his/her name and address here:

________________________________________________________

Mail this form and your check (made payable to Concordia Lutheran Church) to