Shepherd Center Donation Form
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1F O U N DA T I O N
2020 Peachtree Rd., NW
Atlanta, GA 30309-1465
Tel (404) 352-2020
Shepherd Center Donation Form
Please fill out this form and mail to:
Shepherd Center Foundation
2020 Peachtree Road, NW
Atlanta, GA 30309
404-350-7359
PAYMENT METHOD:
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Check
Credit Card
Enclosed is my check in the amount of $__________
Please charge my credit card account using the information below.
(Please make checks payable to
Shepherd Center Foundation)
Amount enclosed $ ______________
Date _________________
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Credit Card gift: Check card type:
Visa
MC
AmEx
Card # ________________________________________________
Exp date (mm/yy)
_______________
YOUR INFORMATION:
Name, (title Mr., Mrs., etc.) _________________________________________________________________________________
Address _________________________________________________________________________________________________
City __________________________________________________________ State ___________ Zip ____________________
E-mail Address _____________________________________ Phone _______________________________________________
MEMORIAL GIFTS
I would like my gift made in the memory of: ___________________________________________________________________
HONORARY GIFTS
I would like my gift made in the honor of: _____________________________________________________________________
OCCASION
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Birthday
Marriage
Recovery from Illness
Confirmation
Baptism
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Engagement
Anniversary
New Baby Graduation
Bar/Bat Mitzvah
Other _____________________
To have a notification card sent, please complete the following:
Name, (title Mr., Mrs., etc.) _________________________________________________________________________________
Address _________________________________________________________________________________________________
City __________________________________________________________ State ___________ Zip ____________________
From: __________________________________________________________________________________________________
(your name as you would like it to appear on the card)
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