CONTACT:
ORGANIZATION:
ADDRESS 1:
ADDRESS 2:
CITY: STATE: ZIP:
WEBSITE: http://_____________________________________________
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Redeem member discounts for online orders, receive customer service emails regarding your account / orders, and subscribe to promotional members-only sale alert emails.
EMAIL ADDRESS:
What animals do you care for? (check all that apply)
___Dogs __Cats ___Birds ___Wildlife
___Other(s) _____________________
Which service(s) do you provide? (check all that apply)
___Shelter __Rescue ___Humane Society
___Other(s) ________________________
SIGNATURE ___________________________ Date____/____/______