Habitat for Humanity - Anchorage

DONATION FORM
  

Is this your first donation to Habitat for Humanity - Anchorage?

___ Yes      ___ No

Is this gift a reply to a solicitation from Habitat?

___ Yes     ___ No      If Yes, which one? __________________________________________________

VISA & MasterCard accepted.

Donation Amount:   $______________ 

Your Information:

Name:______________________________

Address:____________________________

___________________________________

City:_______________________________

State:______________________________

Zip:________________________________

Phone Number:_______________________

Email:______________________________

Would you like to receive our newsletter?

___ Yes      ___ No

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Is your donation being made on behalf of the 2009 Wells Fargo/100 Women House?

___ Yes      ___ No

If YES, please give the name of the person who solicted your donation?

________________________________________________________

If you wish to make this donation in honor of or in memory of a special woman in your life, please complete the next section of this form.

Thank You on behalf of Habitat for your donation to the 2009 Wells Fargo/100 Women House.

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Habitat for Humanity - Anchorage will honor all donations made in memory or in honor of individuals and groups with a donation 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:_________________________

Email:________________________________

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

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If donating by credit card, please enter the following information as it appears on your credit card:

Name:_______________________________________

Credit Card Number:____________________________

Card Expiration:_______________________________

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If paying by credit card you may fax this completed form to: (907) 272-1508

If paying by check or credit card you may mail this completed form to:

Habitat for Humanity - Anchorage

500 W International Airport Rd Ste E

Anchorage, AK 99518

Please do not hesitate to call us at 907-272-0800 if you have any questions. 

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