Cincinnati Habitat for Humanity

DONATIONS > Mail-In Donation Form

Please print this page, fill it in, and mail it to:
Cincinnati Habitat for Humanity
4910 Para Drive
Cincinnati, OH 45237

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**All information in bold must be completed**

Donation

I’d like to support Cincinnati Habitat for Humanity in helping low-income families buy simple, decent, affordable homes. Please accept my donation of:

___ $1000 ___ $500 ___ $250 ___ $150 ___ $100 ___ $50 $__________ Other

Donation Frequency:

____ One Time Gift ____ Monthly ____ Bi-monthly

____ Quarterly ____ Annually ____ Semi-annually

If other than a one-time gift, please indicate when gifts should begin and end:

Begin Date: (Mo./Year) _____/_____ End Date: (Mo./Year) _____/_____

Payment Information

___ Check Enclosed

___ Please charge my tax-deductible gift on: ____

____

___

Name (as it appears on card) __________________________________________________________

Card No. ___________________________________________ Exp. Date (Mo./Year) _____/_____

Card Verification Number _____________________________

Signature __________________________________________________________________________

Donor Information

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.

Memorials and Tributes (optional)

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: _________________________________________________

Please send a note acknowledging my gift to:

Full Name: _____________________________________________________________

Address: _____________________________________________________________

_____________________________________________________________

City: _____________________________ State: _____ Zip: __________

Gift amounts will NOT be disclosed unless otherwise specified.

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