Print, fill out (please print neatly or attach return address label) and mail to: 
BC Humane Society, Box 512, New Ulm, MN  56073  
Make checks payable (do not send cash) to BCHS (minimum $5.00 donation)

Your Name:___________________________________________________________

Your Address:_________________________________________________________

City:___________________ State:___ Zip Code:_______________

Phone:_________________ (necessary if we can't read your writing)

E-Mail:_______________________

Date:__________________

This is a gift donation for:

Name:___________________________________________________________

Address:_________________________________________________________

City:___________________ State:___ Zip Code:_______________  

Amount: ($5.00 minimum donation) ____________________________________

In honor of his - her - their (please circle one)

Event or message:_________________________________________________________

Include date of event or message, if you like:________________________________

The person(s) will receive an acknowledgement in approx. 1 week

Thank you for your donation to the BCHS!

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