Little Star Donation Form

Complete, print, and mail the form below to Little Star Center to make a donation using you Credit Card or Check. Your gift will directly benefit the Little Star Center. All gifts are fully deductible for federal income tax purposes to the extent allowed by law. The information provided on this form will be used only by Little Star School and its agents to process your donation.

Description:

Full Name:*
First and Last Name on the Credit Card (also include if paying by check)

Street Address:*

City:*

State:*

Zip:*

Country:

Phone:

Email: Fill in if you want a receipt emailed

Amount:*

Credit Card #:* Leave blank if paying by check

Exp. Date (mm/yyyy):* (i.e. 06/2005) Leave blank if paying by check

Amount ($):*
(i.e. $100)
Leave blank if paying by check

* Required for Credit Card

Little Star Center, Inc.
12726 Hamilton Crossing Blvd., Carmel, Indiana 46032
Phone: 317-249-2242

Description:
Full Name:*		First and Last Name on the Credit Card (also include if paying by check)
Street Address:*
City:*
State:*
Zip:*
Country:
Phone:
Email:		Fill in if you want a receipt emailed
Amount:*
Credit Card #:*		Leave blank if paying by check
Exp. Date (mm/yyyy):*	(i.e. 06/2005)	Leave blank if paying by check
Amount ($):*	(i.e. $100)	Leave blank if paying by check
* Required for Credit Card
	Little Star Center, Inc. 12726 Hamilton Crossing Blvd., Carmel, Indiana 46032 Phone: 317-249-2242