The Homeless Advocacy Project

"...helping to break the cycle of poverty and homelessness."

Contributor Form

PRINT THIS PAGE
Please print this form and mail it with your check or credit card information to the address below:

Name: ________________________________________________________________

Firm: _________________________________________________________________

Address: ______________________________________________________________

City: _______________________________ State:____________ Zip: _____________

Phone: ___________________________ Fax: ___________________________

Enclosed is a contribution to assist HAP:

_____$50____ $100 ____$500 _____$1000  Other $______


Please bill my credit card: ____Visa/MasterCard ____American Express

Card Number:___________________________ Expiration Date:___________

Signature:___________________________________ Amount : $__________


PLEASE MAKE CHECKS PAYABLE TO THE HOMELESS ADVOCACY PROJECT.

MAIL TO:
Homeless Advocacy Project
Attn: Marsha I. Cohen
42 South 15th Street, 4th Floor
Philadelphia, PA 19102

 

For credit card donations, you may fax this form to:
(215) 981-3866

All contributions are tax deductible to the maximum extent allowed by law. A copy of the official registration and financial information may be obtained from the Pennsylvania Department of State by calling 1-800-732-0999. Registration does not imply endorsement.

Copyright © 2004-2009. Homeless Advocacy Project. All Rights Reserved.

CLOSE WINDOW