McLaren Lapeer Foundation Lullaby Gift Program Form | Lapeer Region Foundation Documents and Links

*Indicates required information

Lullaby Gift program

Please complete and print this form and mail to the foundation.

Donation Amount:

Full name and birth date of baby:

First and Last Names of Parents:

Address of parents:

City:

State:

Zip Code:

Gift From:

Gift from (Enter name and relationship to baby or Anonymous):

Purchaser Information

Credit Card Type:

Name on Credit Card:

Card Number:

Expiration Date:

Signature of Card Holder:

Email Address:

Phone

Cardholder Address:

Cardholder City:

Cardholder State:

Cardholder Zip Code:

To make a Lullaby Gift donation complete, print, and mail the Lullaby Gift Form with your check or credit card info to: McLaren Lapeer Region Foundation
1375 North Main Street
Lapeer, MI 48446
or call 810-667-5586