Become a Luminary

*First Name:

*Last Name:

If this is from a company, please enter company name:

*Preferred Email Address:

Address:

City:

State/Province:

Postal Code:

Employer:

*Preferred Phone Contact Number: Enter a valid phone number.

Tell Us About Your Passion to Become a Luminary:

Would You Be Willing to Volunteer at Events?

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Would Your Employer Be Interested in Becoming A Corporate Luminary?

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*Luminary Level Desired:

Lighthouse* ($100 or more, please specify below)

Beacon ($75 monthly)

Brilliance ($50 monthly)

Radiance ($25 monthly)

Shine ($10 monthly)

Lighthouse Donation Amount :

Forego Name Being Listed on Website :

Forego Gift:

Tax Deduction Statements Will Be Provided at End of Calendar Year.

Please note, in recognition of current IRS regulations, any tax deduction is limited to the excess of the contribution over the fair market value of any items received in exchange for the donation.

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