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Please print and complete this
form and mail it to:
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LHEF, Inc.
484 14th Street
Brooklyn, New York 11215
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( ) Yes, I want to hold a fundraising event to help the Lesbian Herstory Archives.
Please send the Party Packet to:
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Name: _______________________
Address: _______________________
_______________________________
City: ___________________________
State: _________ Zip: ____________
E-Mail Address: ______________________
Telephone Number: ___________________ |
( ) I am sorry that I cannot hold a fundraising event but I want to make a contribution towards the future of the Lesbian Herstory Archives with my enclosed donation. (Please print this form and send it with your donation).
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Name: _______________________
Address: _______________________
_______________________________
City: ___________________________
State: _________ Zip: ____________
E-Mail Address: ______________________ |
PLEASE INDICATE:
Amount of Donation: $_________
Optional:
Donation
is in honor or memory of:
_____________________ |
Please check one of the following to
indicate the form of the donation:
_____ check _____ money order
_____ cash _____ credit card
Please note that the only credit cards we accept are VISA and Mastercard.
Please make checks payable to LHEF, Inc.
If you'd prefer to donate online using a credit or debit card, please go to our Online Donation Form.
For Credit Card Donations:
Please note that your donation will appear as a payment
to "LHEF, Inc." on your credit card statement.
| Type of Card (check one): _____ VISA
_____ Mastercard |
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Name on Credit Card: _____________________
Billing Address: __________________________
______________________________________
Phone Number: ____________________
Today's Date: ______________
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Account No.: __________________________
Exp. Date: _________
Amount to be deducted: $_________
Signature: _________________________
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LHEF, Inc. is a non-profit organization. Your donation is tax-deductible.
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