Light the season with
Lights of Love
Honor
a friend, family member or
co-worker with a Love Light:
 Red represents a living tribute to someone
special
 White honors the memory of a loved one
or someone special
 Blue honors or remembers those who
serve our country.
Single lights are $5 each or you can make a
brighter statement by purchasing a strand(s)
of lights in quantities of 25, 50 or 100 bulbs
for $150, $300 or $500.
Please join us for a lighting ceremony on
December 4 at 4:30 p.m. at St. Mary’s Hospital.
This year’s event will be live-streamed on
the SSM Health St. Mary’s Hospital Facebook
page. We hope you will visit us at facebook.
com/SSMHealthStMarysHospitalMadison
Proceeds from the Lights of Love sale
benefit St. Mary’s Hospital,
patients and the community.
Sponsored by St. Mary’s Hospital Auxiliary
If inclement weather call
(608) 258-6625 for program updates.
The beautiful light display will remain lit
through January 6, 2017.
If you would like a holiday acknowledgment
card sent to a recipient, family member or
friend, please complete the form on the inside.
For recipients’ and donors’ names to
appear on the printed program, orders must
be placed by Wednesday, November 16. Orders
will be accepted through December 24.
Lights of Love
700 South Park Street
Madison, WI 53715
www.stmarysmadison.com
©2016 SSM Health. All rights reserved. SMM_WI_16_234872 9/16
Purchase holiday lights
to honor or remember
someone special.
Tree Lighting Ceremony
and Reception
St. Mary’s Conference Center
December 4, 2016 at 4:30 p.m.
Inclement weather date is December 5
(Same time and location as above)
To purchase one or more lights or strands of lights,
complete the form below and send with your payment to:
St. Mary’s Auxiliary (Lights of Love)
700 S. Park St., Madison, WI 53715
Make checks payable to: St. Mary’s Auxiliary
Form(s) and payment can also be dropped off at
St. Mary’s Gift Shop or the Volunteer Office.
Additional order forms are available by photocopying this
page or online at www.stmarysmadison.com.
Lights of Love 2016
ORDER FORM
Your Name (PLEASE PRINT): __________________________________________________________________________
Address: _________________________________________________________________________________________
City, State, Zip: ____________________________________________________________________________________
(
)
Phone: ___________________________________
Credit Card orders bill:

VISA

Email: _______________________________________________
MASTERCARD
Card # ______________________________________________ Exp. date _____ /______
3-digit security code: _____________
Signature: ___________________________________________
(on back of card)
Lights of Love bulbs are $5.00 each. Or purchase a strand(s) of lights: 25 lights for $150, 50 lights for $300 or 100 lights for $500.
White lights are in memory of those no longer with us. Red lights are in appreciation of those who are living.
Blue lights to honor/remember our military. (One tribute name & acknowledgment card per bulb. Please print legibly.)
 WHITE Light(s)
or  RED Light(s) or  BLUE Light(s) in honor of:
 WHITE Light(s)
or  RED Light(s) or  BLUE Light(s) in honor of:
_____________________________________________________________________________
Please send acknowledgment card to:
_____________________________________________________________________________
Please send acknowledgment card to:
Name: ______________________________________________________________________
Name: ______________________________________________________________________
Address: ____________________________________________________________________
Address: ____________________________________________________________________
City, State, Zip: _______________________________________________________________
City, State, Zip: _______________________________________________________________
 WHITE Light(s)
or  RED Light(s) or  BLUE Light(s) in honor of:
 WHITE Light(s)
or  RED Light(s) or  BLUE Light(s) in honor of:
_____________________________________________________________________________
Please send acknowledgment card to:
_____________________________________________________________________________
Please send acknowledgment card to:
Name: ______________________________________________________________________
Name: ______________________________________________________________________
Address: ____________________________________________________________________
Address: ____________________________________________________________________
City, State, Zip: _______________________________________________________________
City, State, Zip: _______________________________________________________________
 WHITE Light(s)
or  RED Light(s) or  BLUE Light(s) in honor of:
 WHITE Light(s)
or  RED Light(s) or  BLUE Light(s) in honor of:
_____________________________________________________________________________
Please send acknowledgment card to:
_____________________________________________________________________________
Please send acknowledgment card to:
Name: ______________________________________________________________________
Name: ______________________________________________________________________
Address: ____________________________________________________________________
Address: ____________________________________________________________________
City, State, Zip: _______________________________________________________________
City, State, Zip: _______________________________________________________________
TOTAL Enclosed is my gift of $ ______________ toward the Lights
of Love program.
In memory of your loved ones, a photo presentation will be revealed at the reception. If you would like your loved one included, please include a photo and the individual’s name
along with your order or forward it to [email protected]. Photos must be received no later than Wednesday, November 16, 2016. Photos will not be returned.