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Housing Opportunities Made
Equal Gift Membership Form |
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Please print out, fill
in and mail |
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Give a meaningful gift to
the person in your life that already has everything. Not only do
gift memberships make great presents for those you love, but they also
touch your community. Your gift recipient will receive a special letter
informing them of your gift and a year's subscription to our nationally
recognized newsletter, Insight. |
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YOUR INFORMATION |
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Please Circle One: |
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Dr. |
Mr. |
Ms. |
Mrs. |
Other:_________________ |
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Please Print: |
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Full
Name:_____________________________________________________ |
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Address:_______________________________________________________ |
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City:_____________________ State:___________ Zip Code:________ |
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Telephone: (
)_______________________________________ |
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E-Mail Address:________________________________________________ |
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THEIR
INFORMATION |
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Please Circle One: |
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Dr. |
Mr. |
Ms. |
Mrs. |
Other:_________________ |
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Please Print: |
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Full
Name:_____________________________________________________ |
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Address:______________________________________________________ |
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City:_____________________ State:___________ Zip Code:________ |
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Telephone: (
)_______________________________________ |
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E-Mail Address:________________________________________________ |
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Select Type of Gift: |
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$10
Student/limited income membership |
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$30
Individual membership |
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$40
Family membership |
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$50
Contributing membership |
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$100
Patron membership |
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$200
Sponsor membership |
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$500
Benefactor membership |
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How did you hear about HOME? |
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Surfing the web |
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Researching fair housing |
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From
a former client |
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Already familiar with the organization |
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Presentation/Workshop |
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From
a board/staff member, who?______________________________ |
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Promotional material/brochure, located where?____________________ |
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Other, please explain_________________________________________ |
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Please send with a check/money order to made payable to: |
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HOME, Inc. |
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700
Main Street |
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Buffalo, NY 14202 |
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THANK YOU FOR YOUR GENEROUS SUPPORT OF FAIR HOUSING! |
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