Hosanna Industries
Contribution
Work Order Form
| Name:
____________________________________________ |
Phone:
___________________________________________ |
| Address:
_____________________________________
____ |
|
| ____ I want to learn
more about Hosanna Industries. Please send me information. |
____ I want to help
Hosanna Industries complete these work orders through volunteerism. I am available:
______________ ________________________________
_. |
____ I want to help Hosanna Industries
complete these work orders financially:
| ____ $60/year or
$5/month |
____ $120/year or
$10/month |
| ____ $300/year or
$25/month |
____ $600/year or
$50/month |
| ____ $1,200/year or
$100/month |
____ $6,000/year or
$500/month |
| ____ $12,000/year
or $1,000/month |
____ $25,000/year
or $2,084/month |
____ Please accept my one-time gift of: _________________.
____ I want to make sure Hosanna Industries' work orders
are always filled, and I would like to consider Hosanna Industries for my estate planning.
Please send information about your Endowment.
Payment Information
| ____ Personal Check (Payable to:
Hosanna Industries). ____ Credit Card:
____ Visa
____ Mastercard
____ Discover
Acct. #:
______________________________
Expiration Date:
_______________________
Signature:
____________________________ |
____ I authorize Hosanna
Industries to deduct monthly donations automatically: Monthly
debit payments of:
Initiate debit entries to my (select one):
____ Checking Account
____ Savings Account
At the depository financial institution and to debit the
same to such account:
Bank Name:
Bank City:
State: Zip:
Bank Rounting # (ABA#):
Bank Account Number:
Account Name:
Signature:
|
Note to Donors
Pay by Bank Draft:
Hosanna Industries, Inc, will debit your account on the 10th
of every month. Debits will begin he month following receipt of this form. You may cancel
at anytime by calling 724-770-0262. |
You will receive an annual tax deduction letter unless you
request otherwise.
Please return this form with payment to: Hosanna
Industries, Inc., 109 Rinard Lane, Rochester, PA 15074 |
