First name	Last name
Name:

Address: (optional)
	Street 1:
	Street 2:
	City:
	State/Province:
	ZIP/Postal Code:
	Country:

Phone:
E-mail:

Description of Non Monetary Donation:

Thank you for giving.

For information on becoming a member of HUB, visit teamwestus.com

South Lake Tahoe Location: 1201 Rufus Allen Blvd. South Lake Tahoe, CA 96150 mail: P.O. Box 13289 South Lake Tahoe, CA 96151 PH: 530-541 HAND (4263) FAX: 530-541-4266

Oceanside Location: 765 Harbor Cliff Way, Ste. 127 Oceanside, CA 92054 PH: 760-231-7724 FAX: 760-231-7728

---

This Web Page was last modified on October 20, 2007 10/20/07
copyright 2007 Tahoe Helping Hands, Inc.