SMILE Pledge: Date ___________

The Lily Foundation of America Inc.

[a non-religious, non-political and non-profit charitable organization]

“We bring light to humanity”

I like to support the cause by making a tax deductible pledge.

SMILE Scholarship:

Monthly [] $15 Yearly [] $180

5-year [] $800 10-year [] $1500 20-year [] $2800

[** Professional college (Engg, Medical etc.) sponsorship is double the above amounts]

The sponsorship supports a high-school student for tuition, books, uniform and transportation.

Preferences

[] None

[] State ________________

[] School _________________________________

[] In memory of ____________________________

MUST-Provide the info below:

Name: ______________________________________

Address: ____________________________________

____________________________________

Phone: ______________________________________

Email: ______________________________________

I will contribute as below:

[] check is enclosed

[] check is being mailed

[] by other means (you name it)

Signature _____________________________

_____________________________________________________________________________________

Mail to: Lily Foundation, P.O. Box 59824, Dallas, TX 75229

Lily Foundation is a IRS 501(c ) tax-exempt organization.

Visit www.lilyfoundation.org for more information