National Airedale Rescue, Inc.
DONATION FORM
I am making a gift of:
___ $5 ___ $10 ___ $15 ___ $20 ___ $25
___ $30 ___ $50 ___ $100 ___ $200 ___ $500 ___ $1,000
or $ ___________ (Please indicate amount.)
For:
___ General Fund ___ CoverDale ($25) ___ June Dutcher Memorial ($100)
___ Specific dog expenses for __________________________________
(I understand that once the expenses are covered, the remainder will go into the general fund to help other rescue Airedales)
___ In memory of ____________________________________________________
___ In honor of ____________________________________________________'
The name mentioned above is a ___ person ___Airedale
Please fill in your name and address to ensure correct preparation of your receipt for tax purposes.
Name _________________________________________________________
Address _______________________________________________________
City ______________________________ State _____ Zip _______________
Telephone Number ______________________________________________
E-mail Address __________________________________________________
Please check here ____ if you wish to remain anonymous
___ Please send notification of my gift to the following person(s).
Name _________________________________________________________
Address _______________________________________________________
City ______________________________ State _____ Zip _______________
E-mail Address __________________________________________________
Relationship to the person or Airedale being remembered or honored.
Please make your check payable to National Airedale Rescue, Inc. Your check and form should be sent to:
Rusty LaFrance
ATTN: AIREDALE RESCUE
8524 Maggie Ave.
Las Vegas NV 89143
Thank you for your generosity.
National Airedale Rescue, Inc., is recognized as tax exempt under 501(c)(3) of the Internal Revenue Code. Contributions are tax deductible to the extent provided by applicable law and regulations.
Information provided on our Internet site is not intended to be tax or legal advice. Please consult a qualified financial advisor before making a gift.
You may use this space for notes or messages.