Canine Companions Contribution Form

 

 

 

Business Name (If applicable): ______________________________________________

 

Name: ­­_________________________________________________M_____    F_____

 

Address: _________________________________________________ Apt #: _________

 

City: _____________________________________ State: __________ Zip: _________

 

Phone #: __________________ Email: ________________________________________

 

Age: __________      Gender:  M ____ F ____

 

 

 

Donation:

 

_____ $25                               _____ $50                               _____ $100                             _____ $250

 

 

_____ $500                             _____ $1000                           _____ $2500                           _____ Other $________

 

 

 

We are very grateful for your donation. Please take a moment and tell us your reason for donating:

 

________________________________________________________________________

 

________________________________________________________________________

 

 

Are you a pet owner currently or in the past? If so, what type(s) / breed(s)?

 

________________________________________________________________________

 

 

 

We are always in need of leashes, collars, dog dishes, kennels, crates, dog beds and other canine accessories. As much as we welcome and appreciate your donations, please refrain from donating items that should be thrown away.

Mailed to:

Canine Companions

2233 Hamline Ave North

Suite 412

Roseville, MN 55113

Or Fax to:
651-403-6401

 

Phone: 651.403.6400

 

Home

Please Print and Mail or Fax this form to us.