We make a living by We make a life by what we give . – Winston what we get. Beacon House Donation Form You can select how your donation will be spent by choosing from one of our programs, the Adopt campaign, or to provide general support: Churchill. Renewing Life program [$90 participant fee for 8 sessions] Expressive Arts programs [$20 program fee / person] Educational Speaker programs [any amount] General operations [any amount] Other amounts □ [$25] □ [$50] □ [$75] Adopt-the-Beacon House (check your donation level below) Sunbeam □ $9,000 one-time endowment & permanent placement on Adopt-the-Beacon House Wall Ray of hope □ $3,300 annual gift to subsidize programs / operations Spark □ $300 to pay rent for one month Shimmer □ Other amount $_________________ Please state exactly how you wish your gift acknowledged on the Adopt Wall (family, group, organization, in honor of, etc.) ____________________________________________________________________ □ Check for Anonymous Check payment made on _____/_____/_____ or installments of $__________ beginning _____/_____/2013. (For credit card payment, visit justgive.org and use the secure Gift Basket page for Beacon House.) Send your check with this donation form to: Beacon House, Inc. PO Box 1175 Green Bay, WI 54305-1175 Print Name: _______________________________________________________________________ Your Signature: _____________________________________________Date:__________________ Address: _______________________________________ City/State/Zip: _____________________ Email: ________________________________________________________________________ Telephone: (_______) _________________________ Thank you for thinking of Beacon House, Inc. in your charitable giving! Your valued gift is tax deductible to the extent that is allowable by law. “Beacon House supports a whole person approach to helping those experiencing life changing health situations. The programs and services address the body, mind & spirit of healing. I'm grateful to have this in our community,” – Mary A. Connelly, MD ABFP, ABIHM, of Bellin Health – The Cancer TEAM