To make a donation, please print this form and mail it with your check or credit card information.
Credit card payments can also be called in to (805) 781-3088 or faxed to (805) 544-1901.
CONTACT INFORMATION: (please enter all contact info below)

Name:

                                                                                           

Home Address:

                                                                                           

City/State/Zip:

                                                                                           

Home Phone:

                                                                                           

Home Fax:

                                                                                           

Home E-mail:

                                                                                           

Business Name:

                                                                                           

Your Title:

                                                                                           

Business Address:

                                                                                           

City/State/Zip:

                                                                                           

Business Phone:

                                                                                           

Business Fax:

                                                                                           

Business E-mail:

                                                                                           

Please send me:

__ Newsletter   __ Event Invitations  __ E-mail Updates

DONATION INFORMATION: Yes! I would like to help!

__ Check is enclosed (payable to Peoples' Self-Help Housing) for the following amount $__________
__ I would like to pay with my VISA or MasterCard (please complete info below)

Amount:

 $_______________

Visa #
                                                                               

Mastercard #

                                                                                

Name on Card:

                                                                                

Expiration Date:

                                                                                

Signature:

                                                                                

Please apply my contribution to:
__ Health Services    __ Social Services    __ Education Program    __ Other

Please acknowledge my contribution as follows:
Tribute:
  
In Honor of:
 

In Memory of:
 
Anonymous:
 

Please Send Acknowledgement to:

Name:

                                                                                           

Address:

                                                                                           

City/State/Zip:

                                                                                           

Please send me info about other forms of contributions / Planned Giving opportunities: __ Yes    __ No



Peoples' Self-Help Housing
3533 Empleo Street
San Luis Obispo, CA 93401
Call (805) 781-3088 or fax (805) 544-1901

Peoples' Self-Help Housing is a 501 (c) (3) non-profit organization, Federal Tax ID # 95-2750154. 
All contributions are tax deductible.