Beacon House
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Donate with a check by using this printable form and mailing it with your payment to
Beacon House
P.O. Box 29629
601 Edgewood St., N.E.
Washington, D.C.  20017

(T) 202.529.7376
(F) 202.832.9456

Name: __________________________________________________________________

Address: ________________________________________________________________

City, State, Zip: ____________________________________________________________ 

Email/Phone Contact: ______________________________________________________ 

Amount enclosed:

$25 _____ $50_____ $100_____ $250_____ $500_____ $1,000_____ Other_____

Does your place of business provide matching funds? Yes_____ No_____ 

If so please provide 

Company Name: ______________________________________________________ 

Address: _____________________________________________________________

Beacon House is a 501(c)(3) non-profit organization. Gifts to Beacon House are tax deductible.

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