100 for hope individual form

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DOWNLOAD THIS FORM TO REGISTER YOURSELF OR ANOTHER INDIVIDUAL FOR 100 FOR HOPE.

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Contact Linda Robinette at (863)687-4076 x222 for more information

Contact Linda Robinette at (863)687-4076 x222 for more information

Contact Linda Robinette at (863)687-4076 x222 for more information

Group Name: Participant Name: Phone Number: Email Address: Address: City: State: Zip: Amount Given: $

100% of these proceeds go to helping theresidents of Lighthouse Ministries and

the poor families in our community!

Homelessness does not go on vacation

Help us with this grass roots effort to rescue and assist homeless men, women, and children.

Group Name: Participant Name: Phone Number: Email Address: Address: City: State: Zip: Amount Given: $

100% of these proceeds go to helping theresidents of Lighthouse Ministries and

the poor families in our community!

Homelessness does not go on vacation

Help us with this grass roots effort to rescue and assist homeless men, women, and children.

Group Name: Participant Name: Phone Number: Email Address: Address: City: State: Zip: Amount Given: $

100% of these proceeds go to helping theresidents of Lighthouse Ministries and

the poor families in our community!

Homelessness does not go on vacation

Help us with this grass roots effort to rescue and assist homeless men, women, and children.

LMI 2011

LMI 2011

LMI 2011

Check cash

check no.

Check cash

check no.

Check cash

check no.

INDIVIDUAL PARTICIPATION FORM

INDIVIDUAL PARTICIPATION FORM

P.O. Box 3112 | Lakeland, FL 33802863.687.4076 | www.lighthousemin.org

P.O. Box 3112 | Lakeland, FL 33802863.687.4076 | www.lighthousemin.org

INDIVIDUAL PARTICIPATION FORM P.O. Box 3112 | Lakeland, FL 33802863.687.4076 | www.lighthousemin.org

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