Please print the following form. Once completed, remit to:

Historic Eleutherian College, Inc.
6927 W. State Road 250
Madison, Indiana 47250
www.eleutherian.us
(812) 273-9434

Contributions are tax deductible under Section 501 (c) (3) of the Internal Revenue Code.



Yes! Sign me up as a Friend of Historic Eleutherian College

Name: _________________________________________________________
(Required)

Address: _______________________________________________________
(Required)

City: _____________________________ State: _________ Zip: __________
(Required)

Phone: __________________ Email: ________________________________

Donation Amount: ___________________
(Required)

Historic Eleutherian College, Inc. is dedicated to the restoration of the Eleutherian College and related buildings in Lancaster, Indiana.


Donation Payment Methods:

Money Order

Cashier's Check

 

Personal Check   (Check# ____________)

Make checks or money orders payable to: Historic Eleutherian College Inc.
© 2002 Historic Eleutherian College