Celebrate a Life

WILD CANINE RESCUE
Mailing Address:
3309 Robbins Rd #109,
Springfield, IL 62704
Telephone: (217) 652-5505
Email: wildcaninerescue@gmail.com
www.wildcaninerescue.org

Improve the lives of our pet loving community and their pets. Your memorial gift supports the needs of our rescue and its programs to prevent dogs from being euthanized at shelters. Your donation gift is tax deductible.

IN MEMORY OF:

Please designate this gift in memory of the following person or companion animal: *

Person

Pet

Name of above: *

Your answer

I would like the following: *

a photo of person or pet featured on WILD Canine Rescue's website under the Memorial page

a lighted candle image with the person's or pet's name on WILD Canine Rescue' Website's Memorial Page

none of the above

ACKNOWLEDGEMENT INFORMATION

Without reference to the amount given

Name: *

Your answer

Address: *

Your answer

Address 2: (if needed)

Your answer

City: *

Your answer

State: *

Your answer

Zip Code: *

Your answer

Donor Information

Name(s) as you wish to appear in the acknowledgement

Name(s) *

Your answer

Address: *

Your answer

Address 2: (if needed)

Your answer

City: *

Your answer

State: *

Your answer

Zip: *

Your answer

How will you be making your memorial donation: *

Online using a credit card (there will be a link after you submit this form)

Mailing memorial donation to: WILD Canine Rescue 3309 Robbins Rd., #109, Springfield, IL 62704

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