Ask Art Fax Donation Form
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MAIL OR FAX DONATION FORM
(Please Print This Page to Mail Or Fax Your Donation.)

Ask Art
94 Halai Street Hilo, HI 96720    808-935-4723

Yes, I want to donate to help support Ask Art Web Counseling!

DESCRIPTION

AMOUNT

   Donation   

Please bill the following MC/Visa
Name on Credit Card:___________________________________
Credit Card Number:____________________________________
Expiration Date:________________________________________
Signature:_____________________________________________

Name:________________________________________________
Company:_____________________________________________
Address:______________________________________________
City/State/Zip:_________________________________________
Daytime Phone Number:_________________________________
E-Mail Address:________________________________________

Fax this Donation Form to: 1-808-935-4723 or Mail to: 94 Halai Street, Hilo, HI 96720. If you have any questions you may email or telephone.  You may donate with traditional methods such as check or money order also.  Thank you for your donation!
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