Your Donation Will Help Build Stronger Communities!

This form is to be used for submitting Online and CLMS Remittances by Lodge ENF Chairs and Lodge Secretaries. This form can also be used for a one-time Lodge donation. Enter the exact amount of the total donation in the Other box. If using a Lodge credit card, enter the Lodge name under Donor First Name and the Lodge number under Donor Last name. If using a personal credit card, please include the correct billing information. The address entered must be the billing address for the card.

A Batch ID must be entered in the appropriate box below to credit members for their donations. If submitting a one-time donation from the Lodge, please type "Lodge Donation" in the Batch ID/Comments box. An online remittance form is not necessary unless you are crediting individual donors. Again, be sure to enter the exact donation amount below.

Gift Information

Field Is Required Enter A Gift Amount:

Other

Enter amount

$50.00

$100.00

$250.00

$500.00

$1,000.00

Lodge Number (Optional)

Member Number (Optional)

Batch ID or Comments

Donor Information

Donor First Name:

Donor Last Name:

Billing Address

Street 1:

Street 2:

City:

State:

ZIP Code:

Donor Email Address:

Yes, I would like to receive communication from the Elks National Foundation.

Payment Information

Credit Card Information:

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Expiration Date:Select month of credit card Select Expiration Year

CVV Number: What is this?

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2750 N. Lakeview Ave. Chicago, IL 60614-2256 Phone 773/755.4728 Fax 773/755.4729 Email enf@elks.org

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