Name of the pet, or pets, you'd like to sponsor:
        Dog Cat

Your Full Name:
Postal Address:
Telephone:
Email Address:

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	I would like PayPal to set up automatic monthly payments of $  for  months. (Minimum three months at $10 per month, per pet. Note: To set up automatic monthly payments, you will need to have a PayPal account.)
	I would like to sponsor a pet with a one-time donation (minimum $30) of $

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	Please do not display my name on the HART website.
	You may display my name on the HART website. Your name as you would like it to appear on the web site:

  in memory of 
  in honor of 

Would you like HART to notify someone of your donation?

Name:
Email: or	(preferred, saves postage)
Street Address:

Additional instructions/comments: