National Airedale Rescue, Inc.

DONATION FORM

I am making a gift of:

___ $5        ___ $10        ___ $15        ___ $20        ___ $25

___ $30      ___ $50        ___ $100      ___ $200      ___ $500      ___ $1,000

or $ ___________ (Please indicate amount.)

For:

___ General Fund      ___ CoverDale ($25)     ___ June Dutcher Memorial ($100)

___ Specific dog expenses for __________________________________
(I understand that once the expenses are covered, the remainder will go into the general fund to help other rescue Airedales)

___ In memory of ____________________________________________________

___ In honor of ____________________________________________________'

The name mentioned above is a     ___ person      ___Airedale

Please fill in your name and address to ensure correct preparation of your receipt for tax purposes.

Name _________________________________________________________

Address _______________________________________________________

City ______________________________ State _____ Zip _______________

Telephone Number ______________________________________________

E-mail Address __________________________________________________

Please check here ____ if you wish to remain anonymous

___ Please send notification of my gift to the following person(s).

Name _________________________________________________________

Address _______________________________________________________

City ______________________________ State _____ Zip _______________

E-mail Address __________________________________________________

Relationship to the person or Airedale being remembered or honored.

Please make your check payable to National Airedale Rescue, Inc. Your check and form should be sent to:

Rusty LaFrance
ATTN: AIREDALE RESCUE
8524 Maggie Ave.
Las Vegas NV 89143

Thank you for your generosity.
National Airedale Rescue, Inc., is recognized as tax exempt under 501(c)(3) of the Internal Revenue Code. Contributions are tax deductible to the extent provided by applicable law and regulations.

Information provided on our Internet site is not intended to be tax or legal advice. Please consult a qualified financial advisor before making a gift.


You may use this space for notes or messages.

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Airedale Information

The ATCA Rescue & Adoption Committee fulfills the Airedale Terrier Club of America, Inc. ("ATCA") obligation to protect and advance the interests of the breed by providing services to lost, abandoned, abused or unwanted purebred Airedale Terriers.
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