Save-A-Pet Program Donation - Paper / Check / US Mail I would like to be a participant in the Humane Society of Central Illinois Save-A-Pet Program. To help pay for veterinary care and for the care and feeding of animals waiting to be adopted, I would like to contribute the following amount monthly. Please check: _____ $10.00 per month _____ $20.00 per month _____ $15.00 per month _____ $25.00 per month $ _________ per month (please indicate amount) The pets whom you have helped and whose lives you have saved thank you very much! Note: Should at some point I find this a real financial hardship, I understand I am under no legal obligation to pay. I understand this is not a legally binding contract. Name: ___________________________________________________   Phone Number: _____________________ Address: _____________________________________________________________________________________ City: __________________________________________   State: __________   Zip Code: ___________________ Date: _________________________ Please print the Save-A-Pet Program 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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