PLEASE SUPPORT 2018 CHILD ADVOCACY CAMPAIGN NOW

Name*
First Last
Florida Bar Number
Address
Street Address Address Line 2 City State ZIP Code
Firm
Email*
Phone*
Sponsorships:
- Diamond - $10,000
- Emerald - $7,500
- Platinum - $5,000
- Gold - $2,500
- Silver - $1,000
- Angel - $500
- Hero - $250
- Friend - $100
If you would like to donate a different amount you can enter it below:
Total
$0.00
To pay by credit card, click the "Submit" button below (PLEASE NOTE- WE DO NOT ACCEPT AMERICAN EXPRESS); To pay by check, please print form and then mail with your check made payable to Dade Legal Aid to:

Dade Legal Aid/Put Something Back 123 N.W. 1 Ave. Miami, FL 33128
Ph: (305) 579-5733 Ext. 2252 Fax: (305) 372-7693
Email: psb@dadelegalaid.org