DONATION FORM

Please print and complete this form and mail it along with your donation to:

Cape Fear Habitat for Humanity

1208 S. Third Street

Wilmington, NC 28401

Be sure to enclose your check or your credit card information.

DONOR INFORMATION

Name: _______________________________________________________________________

Address: _____________________________________________________________________

_____________________________________________________________________________

City: ________________________________________________________________________

State: ________________ Zip: __________________________

E-Mail Address:________________________________________________________________

PLEASE INDICATE:

Enclosed is my check for $_________ Please charge my gift of $_________

Visa / MasterCard / American Express / Discover

Account No. ___________________________________________Exp. Date ___________

Signature _____________________________________________________________________

Phone Number ________________________________

Please make checks payable to Cape Fear Habitat for Humanity

All gifts are tax-deductible to the extent allowable by law.

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