Angels Surviving Cancer, Inc. Prayer Breakfast
Cancer Awareness Resource Encouragement We are a 501C3 non profit organizaton EIN 45-2903544
Name of Donor
*
First Name
Last Name
E-mail address of Donor
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Business
In Kind Donation Request
Angels Surviving Cancer, Inc.
Describe what you will be donating
small hand sanitizers
Inspirational card
Bags (prefer pink with Angels name)
Small kleenex
gift cards for honorees
Other
Date of Donation(s)
*
-
Month
-
Day
Year
Date of Donation (you can specify multiple dates in your description)
1. Initial
Delivery of item
ASC can pick up item call 281-912-5195
Items can be mailed to 12401 South Post Oak 231 Houston, Texas 77035
Items can be dropped off from 8-5 front desk 12401 South Post Oak 231 Houston Texas 77045
will make Monetary donation on angelssurvivingcancer.org website
2. I understand that the value of the items or services declared for tax exempt purposes.
*
Yes, I do.
No I do not.
2. Initial
E-Signature:
*
Type your name to attest to the truth and accuracy of this form at the time of submission. By pressing submit below your form will be time and date stamped accordingly. Upon receipt, ASC will forward the acknowledgment via email. THANK YOU FOR YOUR SUPPORT! Please keep a copy for your records for Tax purposes. We will provide proof of our 501c3 Non profit status.
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