Animal Health and Safety Associates/Pixie Projects

Yes, I would like to help an animal survive!
Please accept my gift to help care for and rescue abused and unwanted animals.

I want to make a tax deductable donation to be used to help care for abused and disabled animals.


Please print & complete this form and mail or FAX your tax-deductible donation.  
(Please print clearly)
 
NAME: __________________________________________________________________
 
STREET: ________________________________________________________________
 
CITY: ______________________________________STATE: ________ ZIP: ______________
 
PHONE: _______________________ E-MAIL: __________________________________________

I wish to charge my donation to:
 
______________            _________________               ________________

__________$25     ____________$35      ____________$50      ___________$100   ___________$500         Other _____________

Card Number_____________________________________________________________   EXP. Date______________________

Signature___________________________________________________________________________


ALL CONTRIBUTIONS ARE TAX DEDUCTIBLE AS ALLOWED BY LAW
 
Please print this form and mail or FAX to:
Animal Health and Safety Associates
1175 Shaw Avenue #104-151
Clovis, CA 93612
Ph 559-294-1632   Fax 559-291-4032

Thank you so very, very  much.