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Please include our challenge gift in WHQR’s Fall Pledge Drive (October 10-19, 2007). AMOUNT $5000 ___ $2000 ___ $1000 ___ $500 ___ $250 __ CHECK ENCLOSED ___ INVOICE ME ___ CHARGE MY VISA MASTERCARD AMERICAN EXPRESS _____________________________ CARD EXP DATE: ____ NAME ON CARD _________________________________________________ COMPANY NAME _________________________________________________ ADDRESS _________________________________________________ EMAIL __________________________ PHONE __________________________ Please print and return this form by mail or fax, with your contribution/pledge to: WHQR Attn: Robert Beauchene or David Howell 254 N. Front Street Wilmington, NC 28401 F. 910-251-8693 P. 910-343-1640 ext 206 |
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