The Garden Club of Indiana, Inc.
Member of National Garden Clubs, Inc.
 
Habitat for Humanity Contribution Form
 
Individuals, Clubs, and Districts can contribute to this Fund.

Please complete this form, enclose check made payable to The Garden Club of Indiana, Inc.
(in lower left corner of check write Habitat for Humanity)
and mail to the State Scholarship Chairman Ellen Qualkinbush, or your District Director by December 1st.

Date check sent      Check district you are a member of  C     NW     NC     CE        
                                                                                                                        NE      NW      CW              

Check the appropriate category:

Individual Gift Amount:
Club Amount:
District Amount:

 Contact Web Chairman for further information if needed.

District/Club/Person Making Contribution:
Address:
City: State: Zip:
Name of Person Sending Check:
Address:
City: State: Zip:
Phone Number:


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