Request / Donation Form

You may use this form for the following types of donations/requests. Please review the description and information for each category on the guidelines page.
    o  Artifact Donation
    o  Charitable Donation
    o  Volunteer
    o  Newsletter (membership required)
    o  Other (LCHS Wish list fulfillment)
Click DONATE for online
Cash Donations only


Name
Address
City State ZIP
Phone
Email Address
 
Request Type
 Artifact Donation 
 Charitable Donation 
 Other (LCHS Wish list fulfillment)
 Newsletter (membership required)
 
Volunteer Type
 
Description of Artifact or Wish List items that you would like to donate. If a Charitable Donation, please state the pledged amount of donation and on behalf of what person and/or organization
Please review the guidelines for assistance in filling out this section.
Image Verification
captcha
Please enter the text from the image:
[Refresh Image] [What's This?]
Powered by EMF