David's House Needs You!

David's House relies primarily on private funding. About 10% of our operating budget comes from guest room revenue ($10 per family per night), because we strive to keep David's House accessible to anyone, regardless of economic means, whose child is hospitalized. Please help us continue to be a home-away-from-home for these families by contributing generously.

Yes, I'd like to show by support for David's House! Please accept my gift of $____________________________

Method of payment: [] Check or money order
[] MasterCard or [] VISA

Card # ___________________________ Exp. Date________ Signature _________________________________
Card Code __________________ (number following the card number in signature box on back of card)

[] My gift qualifies for a matching funds from my employer-form is enclosed.
[] Please have someone contact me about bequests and other planned giving opportunities.
[] Please have someone contact me about organizing a fundraising event in my area.

Name _____________________________________________________________________________________

Address ___________________________________________________________________________________

City/State/Zip ______________________________________________________________________________

Phone (day)___________________________________ (evening)_______________________________________

My gift is in honor of (name): ___________________________________________________________________
[] Birthday [] Memorial [] Wedding/Anniversary [] Other

Please send an acknowledgment to:

Name _______________________________________________________________________________
Address _____________________________________________________________________________
City/State/Zip ________________________________________________________________________

NOTE: Your contribution is tax deductible to the extent permitted by law. Consult your tax advisor about IRS regulations governing charitable contributions.

Send your contribution and this completed form to:

David's House
PO Box 660
Lebanon, NH 03766-0660

Or fax to 603/643-1625.

Thank you from all of the families who stay at David's House!