(Please print and send completed with your donation to 2424 Wilcrest Drive, Suite 120 Houston, TX 77042).
Name/Organization________________________________________________________
Address_________________________________________________________________
City _______________________ State ___________ Zip _________________________
Phone (day) _________________________ Phone (evening) ______________________
Email Address ___________________________________________________________
Please check all that apply:
[] I am interested in becoming a volunteer.
[] I would like to receive LAH updates and notice of events by email
[] I wish to remain anonymous
[] Enclosed is my tax-deductible donation, payable to Literacy Advance of Houston, in the amount of $__________________.
___ Enclosed is my check payable to Literacy Advance of Houston
___ Please charge my [] Visa [] MasterCard [] American Express
___ My donation is eligible for Corporate Matching, and I am including the necessary information.
#__________________________________________________________ exp ___/____
This gift is [] in memory of [] in honor of (check one)
Name _________________________________________________________________
Address ________________________________________________________________
City _______________________ State ___________ Zip _________________________
Signature of donor
________________________________________________________________________