Pledge Form

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

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 sheila@lucboys.org. We can take your information and run any credit cards for you. Thank you.

 
Your Full Name: 
Address 1: 
Address 2 (optional): 
City : 
State: 
Zip Code: 
International Province/Territory Country
Date: 
Day Phone: 
Evening Phone (optional) 
E-Mail: 
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 $ 
Frequency 
   
Name as it appears on Card 
Card Number 
Expiration Date   mo/year
Three Number Code on Back  cvv2
Payment Method: 
Support Amount $ 
Frequency 
Other Comments