Pledge Form

This form is currently not working correctly. Please call the Ranch at 417-779-5374 or send an email to Sheila Ortman (

If you prefer not to use the form below, you may call us at 417-779-5374 and let us know the nature of your call so that it will be directed to the proper person. Feel free to also contact We can take your information and run any credit cards for you. Thank you.

Your Full Name: 
Address 1: 
Address 2 (optional): 
City : 
Zip Code: 
International Province/Territory Country
Day Phone: 
Evening Phone (optional) 
How did you hear about LUC? 
Specify from above: 
Boy Type: 
When you don’t know a particular boy but want help in choosing one.
Specific Info:    In response to above choice.
Boys Full Name: 
Payment Method: 
Support Amount $ 
Name as it appears on Card 
Card Number 
Expiration Date   mo/year
Three Number Code on Back  cvv2
Payment Method: 
Support Amount $ 
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