Donation Information
Amount
$250.00
$175.00
$100.00
$50.00
$25.00
Type of Donation
Donation
Monthly Donation
Frequency
Monthly
I would like to dedicate this donation
Type of Dedication
In Memory of
In Honour of
In Celebration of
Gift Notes
Tribute's Name
How would you like the notification to be sent?
Mail the notification card directly to the address provided below
Send an email notification directly to the email address provided below
Send the notification card directly to the funeral home where it will be forwarded to the family
I don't wish for the family to be contacted or notified at this time
Please Send the Notification Card to:
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Alberta
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Postal Code
Email
If you'd like us to send the notification card directly to the funeral home, please include their address in the space below:
Please provide a personal message for the family in the space below:
Contact Information
First Name
Last Name
Company Name
Address
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington DC
West Virginia
Wisconsin
Wyoming
Postal Code
Cell Phone
Home Phone
Email
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 Central Alberta Humane Society and I will donate $0.00.
No. I will donate $0.00 and Central Alberta Humane Society will cover the processing costs.
Payment Information
Payment Options
Credit Card
Bank Account
Credit Card Information
Card Holder Name
Visa
MasterCard
Card Account Number
Expiration Date
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
24
25
26
27
28
29
30
31
32
33
34
Security Code
Billing Address
Same As Above
Address
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington DC
West Virginia
Wisconsin
Wyoming
Postal Code
Email
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