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DONATION FORM

FOR MEMORIAL, SPECIAL GIFT

Would you like to surprise an animal lover with a special gift, or celebrate an occasion in a special way? Or would you like to honor the memory of a loved one or special friend, or someone who provides good care for their pets?  Here is a wonderful idea – make a donation to HSMC on their behalf!  A special card acknowledging the gift will be mailed according to your designation below.  You, as the donor, will receive a ‘thank you’ letter.  Your honoree, or his/her loved ones, will appreciate your generous gesture, and at the same time you will be helping our local homeless pets! 

___ In honor of                        ___ In memory of                     ___ In celebration of

- (please print)

Honoree Name(s) 

Event, if applicable

Your name and address, as Donor(s)

Name and Address to receive acknowledgment card

Amount of gift
 (Amount will be confidential and omitted on acknowledgment card)

Make checks payable to “HSMC”
Monies/gifts are tax deductible to the extent provided by the law

Mail to:   P.O. Box 164 , Waterloo IL 62298

Thank you!

All gifts benefit the animals of The Humane Society of Monroe County, IL.
HSMC is a non-profit 501c3 charitable organization supported entirely by donations.

Web Site: www.hsofmcil.org.  Phone (618) 282-PETS (7387).