Printable Form - Fill it out online, then print it and send it together with your check.

Click : "File" - "Print Preview" : 1 page view - Shrink to Fit - Print Document

Papillon Club of America ~ Health & Genetics - Forms - Honor & Brags donation form

YES !!!  I would like to donate to the Canine Health Foundation

to improve the health of our Papillons.

Donation to be matched by the C.H.F.

   

My Memorial Donation is for :  $ ______

----------------------------------------------------------------------------------------------------
  
My information : Please send a commerative card to  :
     

Name : 

Name : 

Address : 

Address : 

City : 

City : 

State : 

State : 

Zip : 

Zip : 

Country : 

Country : 

Phone : 

E-mail : 

Text is limited into 3-4 short sentences to fit 

in the frame, as shown below

 

In memory of : Name 

Dates ( if desired ) / Memorial text

Donation by : Your name

 

Do you want a photo displayed 

on the Memorial Donation page ?

Yes

No

 

Remember to e-mail your photo and information to : Line Leret

----------------------------------------------------------------------------------------------------
Please send a check payable to : 

Canine Health Fund   note: PCA Genetic Memorial Fund
     
Send this form together with your check to :

Leona Domino, 4628 State Road, Medina, Ohio 44256
  

We welcome and appreciate your donation to improve the health of our Papillons !

 

We wish to thank you for your interest and faithful support 

of Papillon Health.

 

Genetic Research Committee

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

  Above Memorials are to be published on the Papillon Club Genetic Web Page & quarterly in Pap Talk

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Papillon Club of America, Inc Health and Genetics