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Donor Form |
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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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