STRIVE MAIL-IN DONATION FORM
STRIVE MAIL-IN DONATION FORM
DONOR INFORMATION
| Name: | _______________________________________ |
| Address: | _______________________________________ |
| City, State, Zip: | _______________________________________ |
| Phone: | _______________________________________ |
| E-mail: | _______________________________________ |
SPECIAL INSTRUCTIONS
[ ] This gift is being made in honor or memory of: _______________________________________
[ ] My company has a matching gifts program, to increase the value of this donation I have included a matching gift form (usually available from your company human resources department). Or have STRIVE contact: _______________________________________
[ ] Other requests/instructions: _______________________________________
PAYMENT INFORMATION
[ ] I have enclosed a check or money order payable to "STRIVE"
[ ] Please charge my Visa / MasterCard / American Express (circle one)
Card Number: _______________________________________ Exp Date: ____/____
Signature: _______________________________________
Mail to:
STRIVE / East Harlem Employment Services Inc.
240 East 123rd Street
New York, NY 10035-2038
STRIVE/E.H.E.S. is an IRS-registered 501(c)(3) nonprofit agency and contributions are tax-deductible to the extent permitted by law. STRIVE will send you a receipt of your donation. Please contact our Development Department for more information: 212.360.1100 or giving@striveinternational.org