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Donation Form

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Donation Form

* If you are having trouble processing donations and are using IE, please try with another browser.

Donation Form

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone
Would You Like to Become A Pawtomatic Donor?*
- Yes, I would like to make a recurring donation.
- No, Thank You.
Select the Amount to Give Monthly
- $25.00 Monthly
- $50.00 Monthly
- $75.00 Monthly
- $100.00 Monthly
- $150.00 Monthly
- $200.00 Monthly
- $250.00 Monthly
- $500.00 Monthly
Donation Amount
- $25 Donation
- $50 Donation
- $100 Donation
- $250 Donation
- $500 Donation
- $1000
- Other: Enter Amount Below
Give A Specific Amount
Is This A Special Occasion or Tribute Donation?*
- Special Occasion Donation
- Tribute Donation
- No, Thank You.
What Type Of Tribute Donation?
- In Honor Of Someone
- In Memory Of Someone
In Honor Of
In Memory Of
Is This A Person Or A Pet?
- Person
- Pet
Card Delivery Options($25 Minimum Donation)*
- I would like to deliver the card myself
- Please deliver a card on my behalf
- I do not want a card
Card Recipient Name*
Prefix First Last Suffix
Card Recipient Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Special Instructions Or Message To Recipient
Type Of Occasion
Date Of Occasion
MM slash DD slash YYYY
Other Options:
- Please Do Not Publish My Name
- Please Send Me Only One Acknowledgement Letter Per Year
- Save a stamp! I’ll keep my confirmation e-mail and don’t need a formal acknowledgement letter.
Would you like to cover the credit card processing fee?*
Ensure Basset Hound Rescue receives your entire donation.
- Sure
- No, Thank You.
CAPTCHA
Processing Fee
Price: $ 1.06
Total
$ 26.06
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

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