WALK FOR THE ANIMALS
Donation Collection Form

First Name: ____________________________

Last Name: _______________________________

Address: ______________________________

City: _____________ State: ______ Zip: _______

Phone: ________________________________

Email: ___________________________________

All proceeds go to support the work of the Animal Protection Society of Durham.

Name
(Please Print)

Street
Address

City

Zip Code

Phone Number

Amount Pledged

Paid

eg: IMA PETLOVER

123 Wag Way

Durham

27704

(919)111-2222

$25.00

$25.00
             
             
             
             
             
             
             
             
             
             
             
             
             
             
 

Total you collected:   $_______________

Total Number of Pages (Attach additional sheets for more pledges). Page _____ of _____

Please make checks payable to "APS of Durham." Sending cash in the mail is not recommended. Please submit a check or your credit card information to the APS of Durham in the amount of the cash donations you receive. For more information, call (919) 593-1883, email development@apsofdurham.org, or visit www.apswalk.org.

 If you are a Team member:

 Team name:_____________________________        Team Captain's name: _______________________________
Mail Registration & Pledges to:
Walk for the Animals
APS of Durham
2117 E. Club Blvd.
Durham, NC 27704		 Pledges are tax deductible. If someone requests a receipt, please contact the
APS Development Office at (919) 593-1883
or development@apsofdurham.org		 Many thanks to you
and your donors for
helping us feed the starving,
heal the wounded, and
house the homeless.