The VHPF Donor Form is ideal when gift-giving In Honor / Memory / Celebration of a friend or loved one.  Please Copy the Form as needed, complete and mail.  Or, Contact Us and we'll complete this Form with you over the phone.

Your Name: ______________________________________

Address: ________________________________________

City: ________________ State: _______ Zip: ___________

Home Phone: _____________________________________

*In Honor / Memory / Celebration, other? ____________

____Please send a card    ____No card needed

Send card to: ___________________________________

Name: __________________________________________

Address: ________________________________________

City: ________________ State: _________ Zip: ________

How you wish the card to be signed:

___________________________________________________

Please make your check payable to: VSSTF/VHPF  

*Gift amounts are confidential.

___Check enclosed ___ Visa ___MC ___AMEX ___Discover

Credit Card Number: _______________________________

Expiration Date: ______/______/______

Signature: _______________________________________

Please forward this Form (and check) to:
Ventura Homeless Prevention Fund
c/o Ventura Social Services Task Force Inc. 

5654 Ralston Street
Ventura, CA 93003

Tax ID # 46 - 4846749