Donation Form

Tribute Gifts

Our lifesaving programs are supported by private donors like you - we receive no government fund. HSWC is a charitable organization 501(c)(3), EIN 62-1582278

Donation

Complete the following fields if this gift is a tribute. (optional)

Type of Tribute

Tribute Name

Contribution Designation

Send Notification to:

Title

First Name

Last Name

Address

Address 2

City

State/Province

Zip/Postal Code

Contact Information

First Name

Last Name

Company Name

Address

Address 2

City

State/Province

Zip/Postal Code

Home Phone

Cell Phone

Work Phone

Help Us Cover Costs

Simply leave "Yes!" checked below to ensure that 100% of your intended donation is available for our mission.

Yes! I want $0.00 to go to Washington County Humane Society and I will donate $0.00.No. I will donate $0.00 and Washington County Humane Society will cover the processing costs.

Credit Card Information

Card Holder Name

Card Account Number

Expiration Date

Security Code

Billing Address

Same As Above

Address

City

State/Province

Zip/Postal Code

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