Dixon Illinois American Legion Post 12 Donation Form
Please fill out this form, print it, send it with your donation or other information to:
American Legion Post 12
1120 West First St., Post Office Box 401
Dixon, IL 61021-0401
Date:
Name: Phone Number:
Mailing Address:
City: State: Zipcode:
E-Mail Address:
______ Direct Donation - Please enclose your check.
Would you like this donation to be used for something specific:
______ Memorial
Name of your loved one:
Would you like this memorial to be used for something specific:
____ Bequest
Date you added the bequest to your will:
Amount of bequest:
Would you like this bequest to be used for something specific: