flower basket donation form

Please fill out the form below. After you submit the completed form you can make your donation using PayPal or a debit or credit card by clicking on the Donate tab at the top or bottom of this page.

Or, you may send a check* to:

Glacial Lakes Conservancy
529 Ontario Ave.
Sheboygan, WI 53081
*Please indicate "Special Flower Offer" in the check memo

* Indicates required field

Name *

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Last

address *

city *

phone number *

Email *

Donation amount (Minimum of $100) *

Is this is gift for someone else? *

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If this is a gift, please provide the recipient's information below...

Name *

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Address *

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Phone Number *

Special delivery instructions *

Submit

Phone: 920-273-1143 Address: 529 Ontario Ave. Sheboygan, WI 53081 Email: [email protected]