Donor Form

Yes! I want to support Habitat’s mission of building safe, decent, and affordable housing in Lebanon County.

 

Name ____________________________________________

             (As you wish it listed in our Honor Roll      c Please do NOT list my name)

Address ___________________________________________

 

City/State/Zip  ______________________________________

 

Home Phone _______________________________________

 

You may use your gift as a way to honor friends and family who care about Habitat for Humanity. This gift is given in  c  Honor of         c  Memory of

 

Name ____________________________________________

 

Please send acknowledgement card(s) to:

 

Name  ____________________________________________

 

Address ___________________________________________

 

City/State/Zip  ______________________________________

 

 

Method of Payment:

 

c  PLEDGE $_________ per house

             c  Charge My Card                               c  Send Invoice

 

c  CHECK: Enclosed is my gift of $_________

 

Mail to:            Habitat for Humanity of Lebanon County

                          1455 E. Main St. Suite 3

                          Annville, Pa 17003

                          Phone:  717-867-1044

                          Email:   habitat@nbn.net

                         

c  CHARGE: My gift of $_________  Please complete the information below)

c  VISA           c  MASTERCARD  _____ CVV(3 digit security code on back)

 

Card #  ______________________________Exp. Date ______________

 

Name on Card ___________________________________________

 

Signature  ______________________________________________

 

c  This gift will be matched by my or my spouse’s employer/company.

 

             _________________________________________________

                                                    (Name of employer/company)

 

 

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