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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
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Cashier's Check
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Personal Check (Check# ____________)
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Make checks or money orders payable to:
Historic Eleutherian College Inc.
©
2002 Historic Eleutherian College |