Circle Tail, Inc.

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Donation Form

Use this form to make general donations to support the programs of Circle Tail or to sponsor a puppy/inmate team or an assistance dog/partner team.

Privacy Statement

Name:
Street Address:
City, State, Zip Code:
Day Phone:
Evening Phone:
E-Mail Address:
Enclosed is my tax deductible contribution:	$
I want my donation to go towards:	General Donation Foster Puppy/Inmate Team Assistance Dog/Partner Team Start Tote for Assistance Dog/Partner Team "Syd's Fund" - for retired Circle Tail Service Dogs Van Fund Other______________
This gift is in memory of _________________________ Send acknowledgement to:   This gift is in honor/ recognition of ________________________(name/ event) Send acknowledgement to:

  Thank you for your support.  Please print and mail completed form, along with tax deductible contribution, to:

Circle Tail, Inc.
8834 Carey Lane
Pleasant Plain, OH 45162