Gift Form

Your support in the form of financial assistance is vital to our mission. Please indicate your interest and support by checking the appropriate box(es) below. 

Complete the form below, print and return to:

a Wish with Wings, Inc.
917 West Sanford Street
Arlington, TX 76012

   I am enclosing a donation of $ .

   Check #   enclosed

   Bill my donation of $    to my credit card.

      Visa       MasterCard       Discover   

Card #:

Name as it appears on card:    

Exp Date:

Signature of Cardholder: 

________________________________________________________

Daytime Phone Number (including area code):

  This donation is given in the name of: 

For one of the following reasons:

  Memorial       Congratulations       Birthday       Wedding Gift    

  Engagement     Birth       Graduation       Anniversary    

  Special Achievement     Other Occasion: 

Recipient's Name: 

Recipient's Address: 

City:   State:    Zip: 

  Please add me to your list of volunteers and send a Volunteer Information Packet to the address below.

  Please send more information about a Wish with Wings, Inc., to me at the address below.

  Please remove my name from your mailing list.  I do not want to receive future mailings.

       Name: 

      Address: 

      City:   State:    Zip: 

  Remember ... many employers will match your gift.  Please obtain a matching gift form from your employer and send it to:  Matching Gifts, a Wish with Wings, Inc., 917 West Sanford Street, Arlington, TX 76012.