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Address 1:  
Address 2 (optional):
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Zip Code:  
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Date:
Day Phone:  
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How did you hear about LUC?
Purpose of donation Please fill in any designated gift in box below or who will be attending the dinner
Specify from above: Name to whom Designated Gift is for or honoring
Help selecting a Boy to Sponsor
 
Specific Info:   In response to above choice  
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Three Number Code on Back  cvv2
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Frequency   Automatically process this amount  as indicated  Yes  No
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Lives Under Construction Boys Ranch, Inc.
296 Boys Ranch Road  ~  Lampe, MO 65681
Contact Person: Ken Ortman, Administrator
Phone: 417-779-5374     Fax: 417-779-
2106
Send mail to webmaster@lucboys.org with questions or comments about this web site.
Copyright © 2003  Lives Under Construction Boys Ranch, Inc.
Last modified: July 28, 2008

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