Embrace Art - Reach out for Peace
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Donation


Print and fill in this form or download as a pdf-file
 

Donation Form (please print clearly)

Date:

  

 

Personal Information
Full Name:      
Last First M.I.
Address:    
Street Address Apartment/Unit #
       
  City State ZIP Code
Home Phone: (   ) Alternate Phone: (   )
E-mail Address:  

 

Total Amount of your Donation enclosed:

$
 

Please make checks payable to GHtA Inc. Mail this form and check to:

Wini King
Attn: GHtA Inc.
9736 East Apache Trail # 13
Mesa, AZ 85207

 

Contributions to GHtA Inc. are tax deductible. Tax exempt status: #74-3149448.