Memorial Donations - Paper / Check / US Mail Your Memorial Donation, tax deductible to the extent allowed by law, can help the Humane Society of Central Illinois in its efforts to prevent animal abuse and neglect through the programs we offer. Memorial Donation for:      Person _______    or    Animal _______ In Memory of: ________________________________________________________________________________ Next of kin: __________________________________________________________________________________ Address of next of kin: _________________________________________________________________________ ____________________________________________________________________________________________ Name of Donor: _______________________________________________________________________________ Address of Donor: _____________________________________________________________________________ ____________________________________________________________________________________________ Amount you wish to donate: ___________________________ Please make check payable to the Humane Society of Central Illinois, print the Memorial Donation form, and mail the completed form along with your check to:

Humane Society of Central Illinois P.O. Box 401 Bloomington, IL 61702-0401

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