Contact Us *Name: *E-mail: Street Address: City: State: Zip Code: *Phone Number: Cell: Affiliation: I would like to learn more about how I can: Bring Light Heart to my community Have Light Heart speak at my event Bring Light Heart projects into my senior residential facility Have Light Heart do an in-service Bring Project H.U.G.™ to my school Sign-up for Inter-generate !™ Workshops Sign-up for Visiting 101™ Do an Internship with Light Heart Volunteer Donate Money, Items or Services Sponsor Partner Be a Corporate Giver Set up a Long-term Funding Plan I heard about Light Heart’s work through: Friends Relatives Media Other: I am familiar with Intergenerational Concepts Yes No I have participated in Light Heart projects? When? What? I would like to submit a testimony Comments / Questions *required
*Name:
*E-mail:
Street Address:
City:
State:
Zip Code:
*Phone Number:
Cell:
Affiliation:
Bring Light Heart to my community
Have Light Heart speak at my event
Bring Light Heart projects into my senior residential facility
Have Light Heart do an in-service
Bring Project H.U.G.™ to my school
Sign-up for Inter-generate !™ Workshops
Sign-up for Visiting 101™
Do an Internship with Light Heart
Volunteer
Donate Money, Items or Services
Sponsor
Partner
Be a Corporate Giver
Set up a Long-term Funding Plan
Friends
Relatives
Media
Other:
Yes No
*required
1672 East Cottonwood Street, Suite B Cottonwood, AZ 86326 Phone: 928-634-0770 Fax: 928-646-7178 Toll Free: 1-888-646-0770 E-mail:
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