Donate-Now
Donate Now

Make a donation to Life Touch
Fill out the form below to complete your donation, and we thank you for your help as we assist others. If your donation is intended to recognize a Life Touch Team Member, please provide their name in the Special Instructions box below.



Donation Type

This donation made by:

Your Name
Your Address
City
State    Zip Code
*For donations from outside the United States, use the address and city fields to put your complete address. Choose "other" from the state drop down and leave the Zip Code blank.
Your Email:



In Memory Of:



To send an acknowledgement of this donation, please fill out the following:
Acknowledgement Recipient Name:
Address:
City:
State:    Zip Code:


Special Instructions:


866-378-0388
Community Wall Brick Purchase
Please complete this form in full. After submission you must complete the PayPal Donate link below the form. The brick will not be processed unless the donation is received.
Please choose the brick format:
Three lines of text, and a maximum of 20 characters, including spaces.
Please send acknowledgement to the following address.
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