Butterlamps Offerings at KTC Minneapolis

Please use your Browser to print this form. To offer butterlamps return your completed form by mail to:

KTC Minneapolis
4301 Morningside Road
Edina, MN 55416-5031
or FAX your completed form to (952) 926-5049

I wish to sponsor the following lamp offering(s):

__ 49-day lamp $75.00 / __ 10-day lamp $30.00 / __ 3-day lamp $10.00 / __ 2-day lamp $7.00

__ 1-day lamp $4. Number of lamps requested ____

My offering is in Honor of:_________________________________________________________(Name)

On the occasion of: ________________________________________________________________.
Please enclose a picture that does not have to be returned for each lamp offered.

Date to start my lamp: _________________. To start a lamp immediately, use a credit card and fax this form to us, or call and talk to us at (952) 926-5048.

Your Name (Please Print):_____________________________________________________________

Address:___________________________________________________________________________

City: ___________________________________ State: ________________ Zip:________________

Email Address:____________________________________________________________________________
(To be held in privacy. If you provide your email address we will confirm your butterlamp offering by email.)

______ Check Enclosed (Please make payable to KTC Minneapolis.)

______ VISA or ______ MasterCard

____ ____ ____ ____ ____ ____ ____ ____ ___ ____ ____ ____ ____ ____ ____ ____
exp. ____/____

Home Phone Number (Please include when using credit card.):

Other things you would like us to know having to do with this offering:

_______________________________________________________________________________________