KNOCK MS OUT OF THE PARK
 
DONATION FORM
 
To make a donation, please fill out the form below.  You may submit the form online or print out and mail the form and payment to:  LHU Softball @ 228 D Thomas Fieldhouse, Lock Haven, PA  17745
 
Name    Phone
Street Address   
City   State   Zip Code
Email
 
Flat Donation Amount:              $
Donation Per Home Run:           $
 
T-shirt Size (if pledge amount matches $5 per home run or greater)
Small      Medium    Large    Extra Large   XXL      
I prefer a hat
 
Method of Payment:     Check           Money Order            Credit Card  
           Please make check or money order payable to the National MS Society and mail to:
          LHU Softball @ 228D Thomas Fieldhouse, Lock Haven, PA  17745.  Please note that
          checks will not be cashed until the end of the season.
 
For donations using credit card:    Visa      Master Card     Discover      AMEX
Credit Card # Exp.   Sec. Code (3 digit # on back of card)
Name on card   
Billing Address (if different from above)
 
Street    City 
State   Zip
 
Referred By: