National Airedale Rescue, Inc.
Dutcher Memorial Statue Donation Form

Please type or clearly print all entries:

Inscription: up to four lines, 40 characters per line, including spaces
(please keep in mind that more characters require a smaller font to fit,
so shorter lines will show up more clearly)





I am making a gift of:

$ ___________ ($300 minimum)

Please fill in your name and address.

Name ___________________________________________
 
Address ___________________________________________
 
City _________________ State ____ Zip Code ________
 
Daytime Telephone Number ___________________________________________
 
Email Address ___________________________________________

Please make your check payable to National Airedale Rescue, Inc.
This form should be sent to: National Airedale Rescue, Inc., 945 N. Stone Ave., Tucson, AZ, 85705

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.