< Please PRINT, FILL and MAIL >

SMILE Pledge: Date ___________

The Lily Foundation of America Inc.

[a non-religious, non-political and non-profit charitable organization]

“We bring light to humanity”

I like to support the cause by making a tax deductible pledge.

SMILE Scholarship:

Monthly [] $20 Yearly [] $200

5-year [] $900 10-year [] $1700 20-year [] $3200

This will help support a disadvantaged high-school student for tuition, books, uniform and transportation.

(Please note professional level career building college students are sponsored at double the amount above.)

Preferences

[] None

[] State ________________

[] School _________________________________

[] In memory of ____________________________

MUST-Provide the info below:

Name: ______________________________________

Address: ____________________________________

____________________________________

Phone: ______________________________________

Email: ______________________________________

I would like to contribute through:

[] checks

[] credit card (Paypal – go to homepage and click)

Signature _____________________________

_____________________________________________________________________________________

Mail to: Lily Foundation, P.O. Box 59824, Dallas, TX 75229

Lily Foundation is a IRS 501(c ) tax-exempt organization.

Visit www.lilyfoundation.org for more information