Printable donation remittance form by tqd15644

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									                           BRIMMING WITH HOPE
                           Printable donation remittance form
                          Print out and complete by hand or typewriter
                               *one hat costs approximately $5.00



[ ] Enclosed is my *gift of: [ ] $5 [ ] $100 [ ] $250 [ ] $500 [ ] Other $___________________

[ ] I/We prefer to use a credit card. Please charge: [ ] Visa [ ] MasterCard

      Acct #___________________________________Exp. Date_______________________
      Name as it appears on card:________________________________________________
      Signature_________________________________Date__________________________

[ ] My employer will match my gift. I have enclosed my company’s form.
       Name (s) (as you wish to be acknowledged)____________________________________
      Address___________________City_______________State_____Zip________________

My gift is:
      [ ] In honor of_____________________________________________________________
      [ ] In memory of___________________________________________________________
      [ ] Other Occasion (i.e. Birthday, Christmas-please specify)_________________________
      [ ] Anonymous____________________________________________________________

Name of person to be remembered or honored as you would like it to appear on the
acknowledgement:

   (Please Print)______________________________________________________________

Please send acknowledgement of this gift to:

   Name____________________________________________________________________
  Address__________________________City_______________State_____Zip___________



   Make your check payable to Hats With Heart and mail, along with this form, to:
                    530 W. 9460 S. Suite A, Sandy, UT 84070
                                  801-567-0066
                        THANK YOU FOR YOUR SUPPORT!
                                                   	
  

								
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