| DONATIONS > Mail-In Donation Form |
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Please print this page, fill it in, and mail it to:
Cincinnati Habitat for Humanity
201 West Eighth Street
Cincinnati, OH 45202 |
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We Accept Visa, MasterCard, and American Express
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| **All information in bold must be completed** |
| Donation |
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| I’d like to support Cincinnati Habitat for Humanity in helping low-income families buy simple, decent,
affordable homes.
Please accept my donation of: |
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___ $1000 ___ $500 ___ $250
___ $150 ___ $100 ___
$50 $__________ Other |
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Donation Frequency:
| ____ One Time Gift |
____ Monthly |
____ Bi-monthly |
| ____ Quarterly |
____ Annually |
____ Semi-annually |
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If other than a one-time gift, please indicate when gifts should begin and end:
Begin Date: (Mo./Year) _____/_____ End Date: (Mo./Year) _____/_____ |
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| Payment Information |
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___ Check Enclosed
___ Please charge my tax-deductible gift on: ____
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Name (as it appears on card) __________________________________________________________
Card No. ___________________________________________ Exp. Date (Mo./Year) _____/_____ Card Verification Number _____________________________
Signature __________________________________________________________________________ |
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| Donor Information |
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Name: ___________________________________________________________________________
Address: ___________________________________________________________________________
City: _________________________________________
State: _______ Zip: _____________
Phone: (____) __________________
E-mail: __________________________________________________________________________
___ My company participates in a matching gift program.
Enclosed is the matching gift form.
A 10% tithe of all gifts is donated to help
build Habitat homes in Kenya unless the donor requests their gift remain
in the local community.
___ I do not wish to tithe my gift. |
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| Memorials and Tributes (optional) |
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If you would like to make your donation in recognition of another,
please complete the optional information below: ____ In Honor of ____ In Memory of
Person's Name: ______________________________________________
Occasion:  _________________________________________________ |
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Please send a note acknowledging my gift to:
Full Name: _____________________________________________________________
Address: _____________________________________________________________
_____________________________________________________________
City: _____________________________
State: _____ Zip: __________
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