ARH Recovery Homew, Inc.: Donation Form

Building a Solid Foundation, One Step at a Time

Addiction is a disease that knows no age, ethnicity, social status, or gender. For every person suffering from addiction others ARE affected—including you!

We are asking you to help continue the services provided by ARH Recovery Homes, Inc. Without your support, organizations like ARH Recovery Homes, Inc. will cease to exist. Without the services and education offered by programs such as ours, those suffering from substance abuse continue on a destructive path that includes child and/or spousal abuse, poverty, disease, suicide, incarceration and/or death. Your donation can help stop the vicious cycle of alcohol and drug abuse. Please, look at your children, your family, your neighborhood, and your community. Imagine the impact that addiction could have.

Give where your heart is; give what you can.

(If you would prefer not to donate online, you can Download a Printable Form)
*Required Fields

We accept checks, or credit card payments thru PayPal.

How will you be paying?
(select one)*

Credit Card thru PayPal

Check (Make check payable
to ARH Foundation)

Select a level *

Step 1 - $25
Step 2 - $50
Step 3 - $100
Step 4 - $250
Step 5 - $500
Step 6 - $1,000
Step 7 - $2,500
Step 8 - $5,000
Step 9 - $10,000
Step 10 - $25,000
Step 11 - $50,000
Step 12 - $100,000

Do you wish your donation to be anonymous?

All information is confidential and will not be shared with
anyone outside ARH Recovery Homes, Inc.

First Name:

Last Name:

Street/PO Box:

City:

State:

* Zip:*

Telephone:

*()- -

Email:

Your employer (for matching funds purposes only)

Yes, I will contact my employer about matching funds.
My employer:
Note: Many employers will match your donation. Please contact your employer to inquire about matching funds.

I was a client of this ARH facility:

None	Fortunes Inn	Benny McKeown Center
Pate House	Treatment Options	THUs-SILUs
Mariposa Lodge	Parisi House on the Hill

How did you hear about ARH?

Other:

Optional: Is this a Tribute Gift?

In honor of:

In remembrance of:

In the name of:

How can we contact this person to ask permission to publish their name? (telephone number, email address, etc)

Note: confidentiality requires that we obtain permission of family and friends before we publish their names.

Comments? Questions? Suggestions?

You can still make changes
while reviewing your donation.

ARH Recovery Homes, Inc. 1101 S. Winchester Blvd. Suite J-220 San Jose, CA 95128 Phone: 408-236-6657