Please print and complete the following information**:

 

            Amount Donated: $______________    Date: _____________________

 

            Your Name: ________________________________________________

 

            Your Address

                        Street: ______________________________________________

 

                        City:    ______________________________________________

 

                        State:  ______________________________________________

 

                        Zip:     _______________

 

            Your Telephone Number: ______________________________

 

            Your Email Address: __________________________________

 

            Are you interested in donating:

                        Your time and labor ______________________________?

                        Materials or equipment____________________________?

 

 

**The above information is necessary to ensure that you will receive a receipt for your donation.  Please make your check payable to:

Highland Rim Habitat for Humanity

(a registered 501(c)(3) organization).

 

Please send your check or money order to:

 

Highland Rim HFH

P.O. Box 1295

Tullahoma, TN  37388