The Lopez Foundation

Thank you for supporting the The Lopez Foundation. Make a donation in your own name, in memory of someone special, or to commemorate a holiday, birthday, wedding or other special occasion. Your gift will help fund the Children’s Summer Camp, Fall Family Camp, and programs which create positive, permanent change for underprivileged children, adults and military families confronting challenges in education and health, as well as increasing community awareness about kidney disease and organ donation. All tributes will be acknowledged with a card in honor of the person, company or occasion you choose.

Please choose your donation amount: *

$50 $100 $200 Other ($5 Minimum)

Credit Card Number*

Expiration Date (MMYY)*

CVV (Security Code)*

Billing Information

First Name*

Last Name*

Address 1*

Address 2

City*

State*

Zip*

Email*

Notifying others of this Gift

Is there someone else that you would like to notify of this gift?
Who would you like to honor or memorialize?

No Yes

Dedication: On Behalf Of In Honor Of In Memory Of

Name:

Address 1:

Address 2:

City:

State:

Zip:

Message:

Mailing Information (If different than billing. For tax form purposes)

Check if your mailing address is different than you billing address

First Name:

Last Name:

Address 1:

Address 2:

City:

State:

Zip:

Donations may also be mailed to:

The Lopez Foundation
Warner Bros.
4000 Warner Blvd., Building 8 – Room 10
Burbank, CA 91522

The Lopez Foundation is a non-profit 501(c)(3) organization; IRS Tax ID # 27-1434363.

Your donation is 100% tax deductible. After donation has been processed, confirmation of donation will be emailed within 24 hours. Please contact us within 24 hours if you donation amount is incorrect.

The information The Lopez Foundation collects for donation purposes is never shared with third parties without your consent. At no time will information collected from you be used for any purpose that is incompatible with the purpose for which it was originally collected or subsequently authorized by you through the exercise of an opt in for that purpose. The Lopez Foundation will never share, sell, or rent individual personal information with anyone without your advance permission or unless ordered by a court of law. Information submitted to The Lopez Foundation is only available to employees managing this information for purposes of contacting you.

http://thelopezfoundation.org/wp-content/themes/wp-framework/library/media/images