| Your Name: |
__________________________________________________ |
| Address: |
__________________________________________________ |
| City, State, Zip: |
__________________________________________________ |
| Phone: |
__________________________________________________ |
| Email: |
__________________________________________________ |
If this is a gift, or is In Honor Of or In Memory Of someone, please
complete the information below. A gift acknowledgment will be send to the
person named.
| Name: |
__________________________________________________ |
| Address: |
__________________________________________________ |
| City, State, Zip: |
__________________________________________________ |
| In Memory Of: |
__________________________________________________ |
| In Honor Of: |
__________________________________________________ |
I want to be a Guardian Angel for ___months
(minimum 3 months at $10/month). I have enclosed a check or money order in
the amount of $ ________.
Name of dog or cat:
________________________________________
Please initial here ____ if you agree to be
named on the website Guardian Angels list.
| SIGNATURE____________________________________ |
DATE______________________ |
Please mail the completed form,
with your check or money order, to:
Furry Suits
Rescue Guardian Angels
c/o Sandy Echeverry
13722 Penwith Court
Chantilly, VA 20151