Please complete and mail this form with your check made payable to Second Harvest
Food Bank to: Second Harvest Food Bank, Attn: Debbie Clark, 3655 Reed Street, WinstonSalem, NC 27107
Your First and Last Name:
Company Name (if applicable) :
Street Address:
City:
State:
Phone:
Zip:
E-mail
☐I want Second Harvest Food Bank to personalize and send
my cards:
Total number of cards ordered:
Total donation:
Requested minimum donation of $10/card
☐ Please personalize my card(s) as follows:
A gift has been made in your honor by:
☐ I am enclosing my list of honorees and addresses.
☐I want to order packs of 10 assorted cards for $25/pack:
Total number of packs (10 cards/pack) ordered:
Total donation:
☐ My check is enclosed with this order form.
Questions? Contact Debbie Clark at 336.784.5770
or [email protected].
GIFT OUTSIDE the BOX ORDER FORM FOR:
(Your Name)
MY HONOREE NAMES & ADDRESSES: (Please make additional copies, if needed.)
Preferred Salutation: (Ms., Mr., etc.):
First and Last Name:
Street Address:
City:
State:
Preferred Salutation: (Ms., Mr., etc.):
Zip:
First and Last Name:
Street Address
City:
State:
Preferred Salutation: (Ms., Mr., etc.):
Zip:
First and Last Name:
Street Address:
City:
State:
Preferred Salutation: (Ms., Mr., etc.):
Zip:
First and Last Name:
Street Address:
City:
State:
Preferred Salutation: (Ms., Mr., etc.):
Zip:
First and Last Name:
Street Address:
City:
State:
Preferred Salutation: (Ms., Mr., etc.):
Zip:
First and Last Name:
Street Address:
City:
State:
Preferred Salutation: (Ms., Mr., etc.):
Zip:
First and Last Name:
Street Address:
City:
State:
Zip:
SECOND HARVEST FOOD BANK OF NORTHWEST NC | 3655 REED STREET | WINSTON-SALEM, NC 27107
PHONE: 336.784.5770 | FAX: 336.784.7369 | WEB: HUNGERNWNC.ORG