Tribute Program Form

A personalized acknowledgement of your gift will be sent to the family or individual honored, without reference to the size of the gift.

c In Memory of _____________________________________________

-- OR –

c In Honor of _____________________________________________

On the Occasion of ____________________________________________

Notify: _____________________________________________

Address: _____________________________________________

(City, State, Zip) _____________________________________________

From: _____________________________________________

Address _____________________________________________

(City, State, Zip) _____________________________________________

Contributions are tax deductible. Please make checks payable to Eliot Unitarian Chapel and send with this form, to the Chapel at 216 E. Argonne, Kirkwood, MO 63122.