Sponsorship Form

I wish to make a contribution to help defray the medical cost of the special needs dogs.


Is there a particular Special Needs Dog that you want your gift to be given? _______

Date:_________________

Name: __________________________________________________________

Address: _____________________________________________________________

City, State and Zip: _____________________________________________________

_____________________________________________________________________

Daytime Phone: _____________________ 

Evening Phone: ______________________

Email:__________________________________________________________________

Dog's Name you want to sponsor: ___________________________________________

Contribution amount:______________________________________________________

I have enclosed a check:___________________________________________________

Please charge my credit card:_______________________________________________

Card type: Master Card and Visa only,

Number and Expiration Date:________________________________________________

Name as it appears on the card:______________________________________________

Comments and Special Instructions:___________________________________________
_________________________________________________________________________
_________________________________________________________________________

I wish my contribution to appear on the website as follows:_________________________
_________________________________________________________________________
_________________________________________________________________________

Please post my contribution anonymously:______________________________________

On behalf of Greyhound Pets of American, Houston Chapter we thank you for your generosity and support of our efforts to find homes for the retired racing greyhound.

Please mail this form:

GPA Houston Inc.
PO Box 741176
Houston, TX 77274

Thank You!