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Donation Form

Giving to Horizons at Foote

Donation Amount:

$25.00$50.00$100.00$250.00$500.00$1,000.00

I would like my donation to recur:

Yes

Amount you would like to recur:

Frequency of donation:

Number of recurrences:

Date of your final recurring donation:

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<<	<	December 2018	>	<<

December 2018
	S	M	T	W	T	F	S
48	25	26	27	28	29	30	1
49	2	3	4	5	6	7	8
50	9	10	11	12	13	14	15
51	16	17	18	19	20	21	22
52	23	24	25	26	27	28	29
53	30	31	1	2	3	4	5

Please confirm recurring donation:

This is a joint gift from myself and:

This is in honor of:

This is in memory of:

Name (s) as it should appear in the Annual Report:

I would like to remain anonymous:

Yes

Do you have matching funds available?

YesNo

Employer or company name for matching gift? (Please contact your company regarding procedure):

Yes, I would like to get involved:

Volunteering
Hosting a fundraiser or reception
Introducing Horizons to my community

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