Print this form and send in with your contribution to the Society.
DONATE BY MAIL FORM
Yes, I want to become a PARTNER and help serve the pets and people of southern Oregon.
Print and complete this form and mail it with your donation to:
Southern Oregon Humane Society
2910 Table Rock Road
Medford, OR 97501
Your tax deductible donation supports our shelter and adoption services for displaced dogs and cats; helps reduce pet overpopulation through spay and neuter programs; works to eliminate the mistreatment of animals through youth and public education; and upholds our full adoption policy.
Name _____________________________________________________
Address ___________________________________________________
City ________________________ State _______ Zip Code __________
Telephone ___________________
Amount of Gift
Enclosed is $ _____________
Payment Options
q Payment in full is enclosed
q One payment on _____________________________
q In two equal payments on ________________ and ___________________
q Monthly starting _____________________________
q Other ( Specify ) _____________________________
q Charge my credit card ___ VISA ___ MasterCard ___American Express
Card Number ___________________________ Expiration Date ________ 3-digit code _______
Signature _______________________________ Date ________________
q Electronic Funds Transfers
Contribution of $ _________ on the ___ 1st or ___15th ( Check One )
of each month from my:
___ Checking Account ( Attach a voided check )
___ Savings Account ( Attach a voided savings deposit slip )
I authorize the Southern Oregon Humane Society to process debit entries to my account. I
have attached a voided check or a voided savings deposit slip.
Authorized Account Signature _______________________ Date ________
Note: Your privacy and security are of utmost importance to us. When you choose to make your gift using electronic funds transfers, you can be assured that it is a safe and secure way to contribute. Also, it saves not only you, but it saves the Humane Society time and money. That means that more of your donation is invested in the vital programs and services for the pets and people of southern Oregon.
THANK YOU !
 | |
|
The above document(s) are Adobe® Acrobat® PDF files and may be viewed using the free Adobe® Acrobat® Reader™. Most newer web browsers already contain the Adobe® Acrobat® Reader™ plug-in. However, if you need it, click on the "Get Acrobat® Reader™" icon to download it now.
|
|
