Hindu Temple and Cultural Center

(A Non-Profit Organization Registered in the State of Washington)
3818  212th ST SE,  Bothell  WA  98021
(425) 483-7115

http://www.htccwa.org

 

Phase-II Capital Campaign

Donation / Pledge Form

Name:
Address Line 1:
Address Line 2:
City:     State:     Zip:
Phone: () -
E-mail Address:


I / We Donate Pledge $

Once
Monthly Quarterly Yearly for a period of Months/Quarters/Years
      starting from

Mode of Payment

Cash
Check #

Credit Card    Visa MasterCard Amex
     Credit Card #:    Expiration Date: /
     Name on Card:




Signature:_______________________________________    Date:___ / ___ / _____