---

Special Donation Form

---

 

Yes! We/I want to support to the Grover Wright or Carole A. Burns Scholarship Fund through an additional donation.

Donations may be made at any time. Those received by April 6 will be included in the 20th Annual Gospel Choir Benefit Program as:

Patron	$25-75
Special Friend	$76-125
Sponsor	$126+
Amount enclosed: ___________

Please fill out and return this form, with your check to:

Lutheran School of Theology at Chicago,
1100 East 55th Street, Chicago, IL 60615.

Please indicate the scholarship in the memo line of the check.

Name: __________________________________________
Address: ________________________________________
City:_________________	State: ________	Zip: ______
_____ Add me to the LSTC Gospel Choir Mailing List.

---