DONATION FORM - It's A Dog's Life Video

 

Please enter your selection below:

            $20             __QTY. DVD (no shipping)                                QTY.                      $20 VHS (no shipping)

            $23             __QTY. DVD (with shipping)                    QTY.                      $23 VHS (with shipping)       

Please indicate donation amount:  $                              (min. amt. to receive free video - $20)

 

First Name:                                                     Last Name:                                                               

 

Please make Checks payable To: Animal Rescue Funding

Payment type: Cash:  Credit Card:               Check:              Check Number:                        

 

CREDIT CARD INFORMATION:

 

Type of Credit Card:  VISA                  MC                    

 

First Name:                                                     Last Name:                                                               

 

CC Number:                                                                          Expiration Date:                          

 

Card Verification Number:                                   (On the back of your card, locate the final 3 digit number)

 

SHIPPING INFORMATION:

 

Address:                                                                                                                                                                                                                                                                               

City:                                                                             State:                          Zip:                             

 

Telephone:                                                                

 

                                                                                                             Date:                                    

Signature for authorization to charge credit card as indicated in Donation Amount:

 

Email (optional):                                                                                                                              

 

Thank you for supporting animal rescue!

For information about how you can help with animal adoption, sponsoring animals, or volunteering, please visit our web sites:

www.pointvicenteanimalhospital.com       or        www.animaladoptioncenter.com

Please Tell Others About This Video!

This video was produced because every animal deserves A Dog's Life! We hope you agree.

www.itsadogslifevideo.com

 

This form may also be mailed with payment to:

30940 Hawthorne Blvd.  Suite 101,  RPV  CA  90275