H.E.L.P. Online Donation Form

YOUTH H.E.L.P. FUNDRAISER ON-LINE DONATION FORM

Please complete the form below to use your credit card to make your tax deductible donations to the FOH Cathy L. Hughes Youth Scholarship Fund. You can also print the form and mail it along with a check/money order payable to Focus on Healing, Inc.. Send contributions to P.O. Box 26132 Washington, DC 20001. Or fax the form to 301.779.8006. Please be sure to include your address and phone number if you're purchasing tickets. If you are making a contribution in an amount that is not listed on the form and would like to pay via credit card, please call 301.779.8005 Press # 3 so that we may take your information over the phone. Thank you!

Name:
Address:
City, State, Zip:
Day Time Number:
Evening Number:

I support the FOH H.E.L.P. Youth Training Program with the following:
I want to sponsor a Youth for the FOH HELP Youth Training Program Reflexology Apprenticeship Program with my contribution of $200 (please select $200 above):
I want to coordinate a youth apprenticeship training program in my: