CREDIT CARD DONATION FORM
Please fill out, print and sign, then fax or mail in this form.

YES! I would like to support Safe Haven Animal Sanctuary.
Contributions are tax deductible under section 501(c)(3) of the IRS code. For more information, please call Safe Haven at (408) 420-SAFE (7233).

2012 Annual Membership Dues$25       2012 Student Membership Dues$15

Enclosed is an additional donation to help Safe Haven
$50       $100       $250       $500       $1,000       Other $
Please charge my Visa MC AMEX Disc/Novus in the amount of $
  Card No. Exp. Date  
  Signature
  Name Telephone  
  Billing Address Email  
  City/State/Zip
Yes, I would like to pledge $ per month to my above credit card.
  For six months       For twelve months       Until cancelled by me
Yes, my company matches contributions. I have enclosed my completed gift form.
This gift is in memory/honor of
Please send an acknowledgement to
  Name Email  
  Address City/State/Zip

Sign Me Up!
Name Telephone  
Address Email  
City/State/Zip
Add me to the Safe Haven mailing list. (Your information will not be shared with other mailing lists.)
Contact me about
Volunteering       Bequests       Donations of Stock       Foster Care       Adoptions
Print this Form

Send to Safe Haven Animal Sanctuary
PO Box 9005
San Jose, CA 95157 		Fax to (866) 833-2451