PARC, Inc. · Park Pal Order Form

Park Pal Options

Please review details to select a sponsorship or membership type here.

Please note, "VIP Level" sponsorships include all Park Pal member benefits (at Family or Grandparent level), plus additional gifts or recognition options.

Amount

*

$5,000 - VIP Level Platinum

$1,000 - VIP Level Gold

$500 - VIP Level Silver

$150 - VIP Level Bronze

$99 - Family

$99 - Grandparent

$75 - Couple

$60 - Single Parent

$50 - Individual

Decline benefits?

*

Do you wish to decline membership benefits and put 100% of your dollars to work for the animals?

Platinum Options

Gold Options

Bill-to Contact Details

Provide contact details for the person who will submit payment for this purchase.

Bill-to Name

First Name

Last Name

Billing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Bill-to Phone #

*

Bill-to Email

Verify Email

Is this a gift for someone else?

*

Member Contact Info

Provide contact detail for the primary individual to receive benefits of Park Pal sponsorship or membership. This is the person we will send packet to and in whose name membership will be recorded.

Member Name

First Name

Last Name

Member Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Member Phone #

Privacy Policy

You may review our Privacy Policy here.

May we send the member occasional e-mail updates?

*

By choosing yes, you "opt in" to receive occasional e-mail updates from Black Pine ONLY.

Member Email

Verify Email