Smith County Habitat for Humanity

                   DONATION FORM


Is this your first donation to Smith County Habitat for Humanity?


      ___ Yes      ___ No


Visa & MasterCard accepted.


Donation Amount:______________




Your Information:


  First Name:____________________________


   Last Name:____________________________


     Address:____________________________


             ____________________________


        City:____________________________


       State:____________________________


         Zip:____________________________


Phone Number:____________________________


      E-mail:____________________________


Would you like to subscribe to SCHFH's quarterly Newsletter?


      ___ Yes      ___ No


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Smith County Habitat for Humanity 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.


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If Donating by Credi 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: (903) 595-2745

OR

If paying by check or credit card, mail to:


Smith County Habitat for Humanity

324 E. Locust Street

Tyler, TX 75702


Please do not hesitate to call us if you have any questions: (903) 595-6630

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