Bayou Area Habitat for Humanity
DONATION FORMIs this your first donation to Bayou Area Habitat for Humanity?
___ Yes ___ No
Discover, Visa & MasterCard accepted.
Donation Amount:______________
Your Information:Name:__________________________________
Address:____________________________
____________________________
City:____________________________
State:____________________________
Zip:____________________________
Phone Number:____________________________
E-mail:____________________________
Would you like to subscribe to Bayou Area Habitat for Humanity's newletter?
___ Yes ___ No
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Bayou Area 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.~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~+~
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: (985) 447-5167
OR
If paying by check or credit card, mail to:Bayou Area Habitat for Humanity
1087 Highway 3185
Thibodaux, LA 70301
ph. (985) 447-6999Please do not hesitate to call us if you have any questions: (985) 447-6999