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Donation Form
Amount
*
$1,000
$500
$250
$175
$100
$50
$25
$10
$5
$
Donation Schedule
One Time
Monthly
Quarterly
Yearly
Continue donating until
(mm/dd/yyyy)
Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Would you like to receive occasional Animal Park news by email?
*
Yes
No
Billing Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Phone
Donation Usage
Please choose a donation type:
*
Personal Contribution
In Honor Of
In Memory Of
Please select donation usage:
*
Unrestricted donation (to be used where needed most.)
Animal Care Fund
General Operating Fund
For a specific item/campaign
Item or Campaign
In Honor/Memory of
First Name
Last Name
Would you like us to notify the recipient or family member of your contribution?
*
Yes, by mail.
Yes, by email.
No, thank you.
Yes, include my name on notification to the family if you have the information available.
Dedication Message (optional):
Send notification to:
First Name
Last Name
Salutation
If the notification should begin "Dear John" then enter "John" here.
Please provide the recipient's complete address address below:
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Please provide the recipient's email address below:
Verify Email
Add 3% to my total amount to help cover the payment processing fees