HWRC ORDER FORM

(PLEASE PRINT OUT AND MAIL TO US)

=========================================================================

ADOPTION: Receive a picture, write-up of arrival, condition, and expectation of Adoptee.

Fees: $10/Month, $25/3Month, $50/6Month, $100/Year, $500 or more/Life $___________

=========================================================================

CONDOLENCE DONATION: The loss of a pet can be as heartbreaking as the loss of a family member.
For a contribution of $20 or more, a condolence card will be sent in your name.

PLEASE PRINT: Species and/or Breed of Animal (example: bird - Hawk)

____________________________________ Call Name:____________________________

Full name and address of receptient:________________________________________

______________________________________________________________________

______________________________________________________________$_______

=========================================================================

DONATION: "EVERY LITTLE BIT HELPS" $______

=========================================================================

NAME:__________________________________________________

ADDRESS:_______________________________________________

CITY, STATE, ZIP:________________________________________

E-MAIL:_________________________________________

HeckHaven is a 501(c) non-profit organization. All donations are tax deductible.
Send Check or Money Order payable to:

HECKHAVEN WILDLIFE REHABILITATION CENTER
6927 Starboard Drive   Lake Charles, Louisiana 70605
Phone: (337) 477-6129   Email: heckhaven@aol.com


HOME