Hundred Nights Inc · New Building Campaign Donation Form

Capital Campaign

Name

*

First Name

Last Name

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Phone

Email

*

Amount

*

$500

$250

$100

$50

$

Donation Schedule

Continue donating until

(mm/dd/yyyy)

Fund

Capital Campaign

This Gift is In Honor/Memory of

In Honor of

In Memory of

Tribute Name

Make your gift in honor or in memory of a friend or loved one.

Notify the Honoree of Your Gift?

Send an email to the honoree notifying them of your gift in their honor.

Yes

No

Tribute Notification: First Name

The first name of the person you would like to notify about your tribute. This is typically the honoree or a loved one of the person you are giving in remembrance of.

Tribute Notification: Email

The email address of the person you would like to notify about the gift you made in their honor or in memory of their loved one.

Tribute: Personal Message

Note/Comments

Thank you for helping Hundred Nights to build a new emergency shelter and resource center!