LegalAid

MID-MINNESOTA LEGAL AID Logo

I want my donation to be designated toward:

I would like to dedicate my donation:

Full name of person honored:

Please send an acknowledgement.

Name & email or postal address of person to receive acknowledgement:

Please type your full name(s) below as you'd like it to appear in our publications. If you prefer to be anonymous, please indicate "anon."

Recognition Name (first & last required)

First Name (as it appears on card)

Last Name (as it appears on card)

Phone Number

Address

City

State

Zip

Prefix

Organization/Business

Business Address (if different from billing address)

Business City/State/Zip (if different from billing)

Card Number

Expiration Date

I would like to cover the payment processing fee.

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