| I
want to help the BC Chihuahua Rescue (BCCR) and
the dogs that they help. Enclosed is my gift of:
$15 ____ $25 ____ $50 ____ $100 ____ $250 ____
$500 ____
other $______
Date: ___________________________________
My name:________________________________
Address:_________________________________
City:____________________________________
Province/State:_______
Zip/Postal:_______________________________
Daytime Telephone: _______________________
Email address: ___________________________
Does your company have a match donations program?
______, If so, who do you work for?
___________________________________________________________________________
If this is a memorial gift, please provide the
following information:
This gift is in memory of: _______________________________________________________
______ Pet ______ Person
Method of Donation:
_____ I have enclosed a check or money order,
payable to the BC CHIHUAHUA RESCUE
The BC Chihuahua
Rescue thanks you for your help!
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