Name of the
pet, or pets, you’d like to sponsor: ______________________ This is a: Dog
Cat
Your Name:
________________________________________________
Address:
________________________________________________
________________________________________________
________________________________________________
Phone:
________________________________________________
E-mail:
________________________________________________
I would like
to sponsor-a-pet for ______ months. (Minimum three
months at $10 per month, per pet.) I would like
to sponsor-a-pet with a one-time donation of $_________.
I have enclosed a check or money-order made
out to HART in the amount of
$_________. Signature ______________________ Date __________
Please do
not display my name on the HART website. You may display my name on
the HART website. Your name as
you'd like it to appear on the
website: ___________________________________________________
in memory of:
______________________________________ in honor of:
_______________________________________
Would you like HART to
notify someone of your donation?
Name:
____________________________________________
Address:
____________________________________________
____________________________________________
I am interested in
volunteering. Please contact me by Email
Phone (or you may complete our
online Volunteer Profile on the website)
Please mail this form
to:
Julie Steven HART Sponsor-A-Pet 7408 Hogarth St. Springfield, VA 22151