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Print
this page and mail to:
American
Red Cross
Hoosier
Hills Chapter
2119 29th Street
Bedford, IN 47421
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Gift Information
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Donation Amount: $
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Designation:
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Please check that your name and address are
correct
to ensure proper preparation of your receipt for tax purposes.
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Name:
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Company/Organization:
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Address:
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City:
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State:
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ZIP:
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Country:
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Telephone Number:
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Email Address:
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Check or Credit Card information.
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Please make checks payable to American Red Cross-Hoosier
Hills Chapter. If you wish to use a credit card, please complete
the information below and mail in this form to the address
listed at the top of this page. Thank you for your support. We
support Visa, MasterCard, and Discover.
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Name on Card:
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______________________________________________
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Card Type:
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______________________________________________
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Account #:
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______________________________________________
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Expiration Date:
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______________________________________________
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