Donation Form

Fill-in and print 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 Full Circle Campaign Foster Puppy/Family Program Foster Puppy/Inmate Team Assistance Dog/Partner Team Starter Tote for Assistance Dog/Partner Team "Syd's Fund" - for retired Circle Tail Service Dogs Van Fund (to purchase a new vehicle) 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 your tax deductible contribution, to:

Circle Tail, Inc.
8834 Carey Lane
Pleasant Plain, OH 45162
Phone: 513-877-3325
Fax: 513-945-3349