THANK YOU FOR YOUR DONATION

PLEASE PRINT THE FORM BELOW
USING THE PRINT OPTION FROM YOUR BROWSER.
THEN MAIL TO THE ADDRESS INDICATED ON THE FORM


Help restore the Historic Johnston-Hall Hospital

Room Sponsors

Platinum $2,500 and up ___________
DONATION  PAGE
Please return completed form to a Hope for Life Family Volunteer
or mail to HFLF, 220 South Wall Street, Calhoun GA 30701

____Visa ____Master Card ____American Express ____Discover ____check

Card Number__________________________________ Expiration date___________

THANKS AGAIN!
Gold $1,500 _____________ Silver $1,000 ____________Bronze $500________________

Wall of Fame $100_____ Date of Birth_________________ Donation_________________  

Company/Organization_________________________________________________________

Name________________________________Contact Person__________________________  

Address____________________________________________________________________  

City_________________________________State___________Zip Code________________
The Hope for Life Family