HabiJax
Habitat for Humanity of Jacksonville, Inc
DONATION FORMIs this your first donation to HabiJax?
___ Yes ___ No
Visa & MasterCard accepted.
Donation Amount:______________
Your Information:Name:__________________________________
Address:____________________________
____________________________
City:____________________________
State:____________________________
Zip:____________________________
Phone Number:____________________________
E-mail:____________________________
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HabiJax will honor all donations made in memory or
in honor of individuals and groups with a gift announcement mailed to
your designee. To designate your donation, please complete the following:____Honorarium ____Memorial
Name of Honoree: ____________________________
Please mail acknowledgement card to:
First Name:____________________________
Last Name:____________________________
Address:____________________________
City:____________________________
State:____________________________
Zip:____________________________
Phone Number:____________________________
E-mail:____________________________
Please allow 8-10 working days for your acknowledgement card to reach its
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If donating by Credit Card, please enter the following information as it
appears on your credit card:Name:____________________________
Credit Card Number:____________________________
Card Expiration:____________________________
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If paying by credit card you may fax this completed form to: (904) 798-2728 Attn: Development Office
OR
If paying by check or credit card, mail to:
Habitat for Humanity of Jacksonville, FL
Development Office
2404 Hubbard St
Jacksonville, FL 32206
Please do not hesitate to call us if you have any questions about your contribution: (904) 208-6651