Habitat for Humanity of Durham

DONATION FORM


Is this your first donation to Habitat for Humanity of Durham?


___ Yes      ___ No


Discover, Visa & MasterCard accepted.


Donation Amount:______________

Your Information:


Name:__________________________________


Address:____________________________


____________________________


City:____________________________


State:____________________________


Zip:____________________________


Phone Number:____________________________


E-mail:____________________________


Would you like to subscribe to Habitat Durham's quarterly Newsletter?


___ Yes      ___ No


~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~

Habitat for Humanity of Durham will honor all donations made in memory or

in honor of individuals and groups with a gift announcement mailed to

your designee.  To designate your donation, please complete the following:


____Honorarium    ____Memorial


Name of Honoree: ____________________________


Please mail acknowledgement card to:


First Name:____________________________


Last Name:____________________________


Address:____________________________


City:____________________________


State:____________________________


Zip:____________________________


Phone Number:____________________________


E-mail:____________________________


Please allow 8-10 working days for your acknowledgement card to reach its

destination.


~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~

If Donating by Credit Card, please enter the following information as it

appears on your credit card:


Name:____________________________


Credit Card Number:____________________________


Card Expiration:____________________________


~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~

If paying by credit card you may fax this completed form to: (919) 682-0947

OR

If paying by check or credit card, mail to:


Habitat for Humanity of Durham

215 N. Church St.

Durham, NC 27701


Please do not hesitate to call us if you have any questions:  (919) 682-0516

Close Print Window