Responsible Pet Care of Oxford Hill

Honor and Remember Gift Giver's Form


Send this form with your payment to the address below. You may also print an "In Honor Of" certificate to send to the recipient.

PLEASE PRINT CLEARLY

For what occasion are you using the Honor and Remember Program? (Please cirlce)

Birthday          Get Well     Congratulations     In memory of deceased family member, friend, or pet

Other ___________________

Did you download the "In Honor Of" certificate to send to the recipient? _____Yes      _____No

ABOUT YOU

Your Name ________________________________________________________  Donation Date_______________

Your Address

Street ______________________________________________________

Town _________________________   State _____  Zipcode __________

ABOUT THE PERSON OR PET BEING HONORED OR REMEMBERED

Name of person or pet being honored or remembered ___________________________________________

Is this a person or a pet? Type of pet __________

Name of person who should receive the acknowledgement ______________________________________

Address of person receiving the acknowledgement

Street ______________________________________________________

Town _________________________   State _____  Zipcode __________

Do you wish the recipient be told of the amount of your gift? _____Yes     _____No

When we receive this form with your check we will notify the person you have designated about your unique gift and how it will help RPC. We will also send you an acknowledgement of your tax-deductable donation.

Enclosed is my check for $______ payable to "Responsible Pet Care." Mail to:

Responsible Pet Care
P.O. Box 82
Norway, Maine 04268

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