Pooch Heaven Donation by Mail

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Donations are tax-deductible. Tax ID# 95-4813550

Please choose the amount of your donation:
Monthly Donations		One Time Donation
$20   _______ per month	$40   _______ per month	Amount $________
$60   _______ per month	$80   _______ per month
$100 _______ per month	Other_______ per month

Please enter your name and mailing information:
Name: _________________________	Address: ________________________________
City: _________________________	State/Province: ___________________________
Zip/Postal Code:  _______________	Country: ________________________________
Phone: ________________________	e-mail:  _________________________________

Select type of payment		CHECK ____        CREDIT CARD ____
Enter information as it appears on your credit card:  (if Payment Method is Credit Card)
Visa ____	Master Card ____	American Express ____	Discover ____
Credit Card #____________________		Expiration Date _____________
Name: _________________________		Address:______________________________
City: ___________________________		State: ______      Zip /Postal code: __________

Enter Banking Information  (if Payment Method is Checking Account)  (USA only)
Bank Name: __________________________	Account # _____________________
ABA Routing Code: ___________________
Send your checks to:    Pooch Heaven    17328 Ventura Blvd #169    Encino, CA 91316
Thank you for supporting Pooch Heaven!    For more information call: (866) Pal-4-Life