Appeal Letter Donation FormAppeal Letter Donation Form YES! I will give the gift of hope to those in need.I will help support the mission of Hope Clinic and Care Center with my/our gift of: $50 $100 $150 $250 $500 $1,000 $$YES! I would like to support the Clinic monthlyStarting with my donation today, I will help by sending a gift: Monthly QuarterlyThis monthly/quarterly donation will be for: $$YES! Please add my name and email to receive the monthly updates from the hope Clinic and Care Center.Pease provide your name and email address (make sure to check the boxes next to each entry). Name:Name: Email:Email:Method of donation: Check enclosed (payable to Hope Clinic and Care Center, mail to 1814 Appleton Rd, Menasha, WI 54952) Option Charge my credit card (see below)Donation information (make sure to check the boxes next to each response): Gift Amount: Option If a monthly donation, enter $:Credit card type: Visa Discover American Express MasterCardCredit card information (make sure to check the boxes next to each entry). Name on card:Name on card: Card number: Card number: Expiration date: Expiration date: CVV number: CVV number: Billing address:Billing address: Cardholder’s signature: Clear SubmitΔ