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Donation Certificate Worksheet


Please fill out the following sections completely. We will custom print each certificate using the information you provide. The donor section should contain information about you. In the Recipient Section, please provide information about the individual who is to receive the certificate. Should you have questions regarding formatting or information placement, please see the Donation Certificates image or e-mail Heather Bowden.

Donation Certificates can be issued in any amount (over $5).

Information about the Donor:

Contact Name:
Street Address:
Postal/Zip Code:

Payment Method?
I will send a Check to the address provided below;
I will send a Money Order to the address provided below;
I will provide my Visa/MasterCard information via the secure shopping cart payment form;
I will use PayPal via the secure shopping cart payment form.

Donation Certificate Recipient:

Name (to Appear on Certificate):
Street Address:
Postal/Zip Code:


The information provided in the Donation Certificate Section will be used to create and send a custom printed certificate to the above named individual(s). A formal donation letter will be sent to you utilizing the contact information you provided in the Donor Section. This donation letter will include the donation date, amount donated, and our Federal Tax Number. Please remember that all donations are tax-deductible and are very much appreciated. If you would like to include a personalized phrase, please feel free to do so in the Comments box in the section above.

To complete your request:

Please fill out this form completely, including your e-mail address. The requested information you provided in the donor information section will allow us to contact you in the event of questions concerning your certificate order.

After you submit the above information, you will need to provide payment information. Please follow the link at the bottom of the Donation Form Results page to complete the donation process.

Visa LogoMasterCard LogoTo make a donation by credit card, fill out and submit the information via our secure shopping cart to process your donation.

Make payments with PayPal - its fast, free and secure! Should you prefer to make your donation using PayPal, we have provided a direct link via our secure shopping cart to process your donation..

If you wish to pay by check or money order, when your form is complete, please submit it (you may wish to print a copy for your records) and mail a copy, along with your check or money order, payable to LABMED, to:

3941 Legacy Drive, Suite 204, #A115
Plano, TX  75023

When your donation is received we will custom print and ship your certificate. If you have any questions, please contact us at 972-208-2470.



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