Mail-In Donation Form

Please Print and Send to:

Sisters Of The Road
133 NW Sixth Avenue
Portland, Oregon 97209
Phone: (503)222-5694
Fax: (503)222-3028

YES!,  I want to help Sisters work toward alleviating hunger and building supportive community in Old Town/Chinatown by making a donation.

(  )  $35.00     (  )  $50.00     (  )  $100.00     (  )  $250.00     (  )  Other $____________

Name: ____________________________________

Daytime phone: _________________

Address: _____________________________________________________________________

_____________________________________________________________________________

__ My check is enclosed. __ Please charge my VISA/Mastercard.

VISA/Mastercard No.:___________________________________

Exp. Date: ______________________________

Signature: ________________________

This donation is in memory of/honor of (please circle one): _________________________

Please send acknowledgement card to: (name/address)

______________________________________________________________________

______________________________________________________________________

Thank you for your support of Sisters Of The Road!