Blue Water Habitat for Humanity
DONATION FORMIs this your first donation to Blue Water 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 Blue Water Habitat for Humanity's quarterly Newsletter?
___ Yes ___ No
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Blue Water 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
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If donating by Credit 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: (810) 985-4798
OR
If paying by check or credit card, mail to:Blue Water Habitat for Humanity
2929 Lapeer Road, Suite B
Port Huron MI 48061-1867Please do not hesitate to call us if you have any questions: (810) 985-9080