Legacy Legion – make a donation to enroll below! *For more information before completing your enrollment form, please click HERE. Legacy Legion (2019 enrollment form) Donor's Name* First Last Donor's Billing/Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Donor's Phone Number*Phone typeMobileHomeWorkOther PhoneDonor's Email address* About Your Legacy Legion ListingUse the options below to enter your listing exactly as you wish it to appear. If honoring a deceased ancestor or family member, please use the "In Memory of" option below. How many Legacy Legion listings? ($100 donation per listing)*Please indicate the TOTAL number of listings you are requesting. Price: $100.00 Quantity: Name: Individuals or Couples Mr.Mrs.Mr. & Mrs.MissMs.Dr.Prof.Rev.Hon. Prefix First Middle Last Suffix For families, groups, organizations or companiesUse this space for a family or organization listing showing EXACTLY how you wish the listing to appear. (for example: The Woods-Moliere Family or St. Augustine H.S. Alumni Houston Chapter) Max = 75 characters, including spacesFor listings "In Memory Of"Use this space to list the name(s) of a deceased loved one or ancestor (individuals or couples) Mr.Mrs.Mr. & Mrs.MissMs.Dr.Prof.Rev.Hon. Prefix First Middle Last Suffix Additional HonoreesIf you are submitting multiple donations, please add the names for additional listings below. Please enter one name per line, following the same format shown above. Would you like to include your honoree in the "Family Legacies" publication?YesNoPlease have the editor contact me regarding the following options, for the "Family Legacies" publication: I would like to submit a photo of this honoree. I would like to submit a more detailed entry and narrative description for this honoree. If you would like to include a photo, you may upload by clicking below, or email it later to ll@lacreole.orgOptional - Narrative Description of the Honoree(s)If you choose to submit your narrative description at this time, we have listed below some suggestions for what you might include. These topics will provide a useful historical reference; however, please feel free to write what you feel best honors your ancestor or relative. [Date and place of birth * Parents of Honoree * Education * Date and place of marriage (name of spouse) * Military (if applicable) * Career/ Work * Children including names, date of birth, and spouses (if married) * Special memories and accomplishments]** Final Check ** (Please take a moment to double check the accuracy of your donor information and spelling of your listings, then submit.)Total $0.00 NameThis field is for validation purposes and should be left unchanged.
