Love Light Donation Form
Please submit one Love Light donation per form.
Donor's Name
*
First Name
Last Name
Company/Organization
If gift is from a business or institute
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
My gift is:
*
In honor of
In memory of
Honoree Name
*
One light per individual or couple
Please send my gift notification to (Recipient):
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Symbolic Tree or Light in honor or memory:
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( X )
Supernova Light
The honoree recipient receives an acknowledgement card and a personalized ornament of the donor's honoree name plus a second line (if desired) via mail. The donor receives a duplicated honoree ornament or may customize their own ornament to receive via mail. Honoree is recognized in the garden during Love Light season and in The Moultrie Observer's Christmas edition. *See Personalization Section below for the Supernova Light.
$
250.00
Super Star Light
The honoree recipient receives an acknowledgement card and a personalized ornament of the donor's honoree name plus a second line (if desired) via mail. Honoree is recognized in the garden during Love Light season and in The Moultrie Observer's Christmas edition. *See Personalization Section below for the Super Star Light.
$
100.00
Star Light
The honoree recipient receives a festive acknowledgment card of the donor's gift via mail. Honoree is recognized in the garden during Love Light season and in The Moultrie Observer's Christmas edition.
$
50.00
Love Light
The honoree recipient receives a festive acknowledgement card of the donor's gift via mail. Honoree is recognized in the garden during Love Light season and in The Moultrie Observer's Christmas edition.
$
25.00
Care Light
Honoree is recognized in the garden during Love Light season and in The Moultrie Observer's Christmas edition.
$
10.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Ornament Personalization
For Supernova Lights and Superstar Lights
If
you chose the Supernova Light:
My Honoree Ornament Second Line (designed for special dates)
I choose to:
Duplicate my honoree ornament for my own ornament
Personalize my ornament with text below
Personalize my ornament with:
21 Character Limit
If you chose the Super Star Light:
My Honoree Ornament Second Line (designed for special dates)
Submit
Should be Empty: