DONATION FORM

If paying by credit card, you may fax this completed form to:  512-472-6235 fx
OR
Mail to:

Austin Habitat for Humanity
310 Comal, #100
Austin, TX  78702

Is this your first donation to Austin Habitat for Humanity?      ___ Yes      ___ No
Visa, MasterCard & American Express accepted.

Donation Amount:______________

Your Information:  

First Name:____________________________   Last Name:____________________________    

Address:_____________________________________, City:________________      

State:_______,         Zip:______________

Phone Number:____________________     E-mail:____________________________

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

___ Yes   ___ No

~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~
Austin Habitat for Humanity will honor all donations made in memory orin honor of individuals and groups with a gift
announcement mailed toyour 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 card:

Name:__________________________

Credit Card Number:____________________________

Card Expiration Date:____________

~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~,~~,~,~,~,~,~
Please do not hesitate to call us with your questions:  472-8788

THANK YOU!


Close Print Window