HART Sponsor-A-Pet Form

Name of the pet, or pets, you’d like to sponsor: ______________________

This is a:   Cat   Dog

Your Name: ________________________________________________ Address: ________________________________________________   ________________________________________________   ________________________________________________ Telephone: ________________________________________________ Email: ________________________________________________

I would like to sponsor a pet for ______ months. (Minimum three months at $10 per month, per pet.) I would like to sponsor a pet with a one-time donation of $_________.

I have enclosed a check or money-order made out to HART in the amount of $_________.

Signature ______________________ Date __________

Please do not display my name on the HART website. You may display my name on the HART website.   Your name as you'd like it to appear on the website: ___________________________________________________   In memory of: ______________________________________ In honor of: ________________________________________

Would you like HART to notify someone of your donation?

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

I am interested in volunteering. Please contact me by:   Email     Telephone   (or you may complete our online Volunteer Profile on the website)

Please mail this form to:

HART Sponsor-A-Pet P.O. Box 7261 Fairfax Station, VA 22039-7261

Thank You So Much!!!!