Please print and complete this form and mail it along with your donation to: Habitat for Humanity International 121 Habitat Street Americus, GA 31709-3498 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 Habitat for Humanity International. All gifts are tax-deductible to the extent allowable by law. For more information, call 1-800-422-4828 (1-800-HABITAT). Habitat for Humanity International makes every effort to honor your designation; however Habitat reserves the right to apply funds to another purpose if in the sole judgement of the Board of Directors of HFHI, the original designation becomes, in effect unnecessary, incapable of fulfillment, or inconsistent with the charitable needs of the community or area served. Form #101w02