Donation Form

Puppy Gram or Kitten Gram

Your $50 Puppy or Kitten Gram includes 20 minutes of playtime, a Rose and Chocolates for your Valentine.

Kitten-Grams or Puppy-Grams Sold Out

Please Choose to send a Puppy Gram or a Kitten Gram

Puppy Gram

Kitten Gram

Please Choose Date to Send

February 13, 2017

February, 14, 2017

Amount

$50

Recipient Information

First name

Last Name

Phone Number

Delivery Address

Within Washington County, TN

Best Delivery Time:

Sender's 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

Privacy Policy
We keep your personal information private and secure. When you make a payment through our site, you provide your name, contact information, payment information, and additional information related to your transaction. We use this information to process your payment and to ensure your payment is correctly credited to your account.

Contact Us: The Humane Society of Washington County •• 2101 W. Walnut Street, Johnson City, TN 37604 •• 423-926-8533 •• [email protected]