Thank you for you tax deductible contribution:

$1000 $500 $100 $25 Other___________________

Please print your name and address:

Name: __________________________________________________________________

Address: ________________________________________________________________

City________________State/Providence_______________Zip/Postal Code__________

Phone number:______________________E-mail address_________________________

If you would like your contribution to be in honor or memory of an individual or family, please designate their name(s) below.

In memory of:__________________________________________________________

In honor of: ___________________________________________________________

In honor of my mentor: _________________________________________________

Identify below who you would like to be notified of your thoughtfulness:

Name:__________________________________________________________________

Address: ________________________________________________________________

City________________State/Providence_______________Zip/Postal Code__________

Gifts to Healing Touch International Foundation are tax deductible in accordance with current federal tax laws.

Please print this form, fill it out, include your contribution and send to:
Healing Touch International Foundation, Inc
16211 Clay Road, Suite 106, Box 215
Houston, TX 77084

Your gift is greatly appreciated.