Yes! I want to support the work of the Golden Retriever Foundation.

Name: ______________________________________________________________________

Address:_____________________________________________________________________

City_________________________________________State_____________Zip Code_______

Amount of Donation $________________________ Date__________________________

Method of payment

Check_____MasterCard_____ Visa________Stock Transfer (*see instructions below)____________

Card # ____________________________________ Exp. Date___________________________

Signature______________________________________________________________________

I wish my gift to go to: General Fund___Zeke Cancer Fund___Rescue Fund___April Fund____

This donation is made:____in honor of OR ____in memory of

___________________________________________________________________________

___________________________________________________________________________

Please send a notice of this gift to:
Name________________________________________________________________________
Address______________________________________________________________________
City____________________________________State_________Zip Code_________________

*The Golden Retriever Foundation maintains an account with Paine Webber through which stock transfers may be achieved. If you wish to make a stock transfer, please contact Barbara Zelechoski, GRF Secretary-Treasurer, (402) 289-4136, e-mail: info@goldenretrieverfoundation.org

All donors and memorials will be acknowledged by letter and will be published in the Golden Retriever News. If you do NOT wish the recognition in the News, please check here.
_______________________________
Please send your tax deductible donation to: Golden Retriever Foundation
P.O. Box 628, Elkhorn, NE 68022