Helping Lupus Patients Realize Their Academic Dreams

Your gift will help in the mission of the Latreese Nicole Fagan Memorial Scholarship Fund, Inc. (LNFMSF) to support the academic future of many lupus patients.  LNFMSF, Inc. has obtained its non-profit 501(c)(3) classification with the Internal Revenue Service. Make your tax-deductible check or money order payable to the "LNFMSF, Inc."

Enclosed is a tax deductible contribution of $_________(your check will be your receipt).

For the Latreese Nicole Fagan Memorial Scholarship Fund, Inc.:

In the Memorial of / Tribute of:_________________________________
(If tribute)on the Occasion of: ____________________________________

If there is more than one donor, please list on a separate piece of paper.

Donor Name__________________________________________________
Address_______________________________________________________
City________________________State__________________Zip_________
Phone________________

We will send an acknowledgement of your thoughtfulness to the address listed below:

Name________________________________________
Address_________________________________________
City__________________State________Zip_________

LNFMSF, Inc. is appreciative of all donations. Since our beginning, hundreds of people have found deep satisfaction in making memorial and tribute donations to honor loved ones and friends. In this way they serve the living pursuing their academic goals and pay thoughtful tribute to the memory of a friend or loved ones.

Please send this form along with your donation to:

Click this link to load the Acrobat version of the form to print.
The Acrobat version will require the Free reader which you can download here