The Washington Humane Society

	To make an online donation via credit card, to support our Sophie’s Fund to help pay for the emergency medical needs of animals in our care please fill out the following form:

	First Name:
	Last Name:
	Address:
	City:
	State:
	Zip:
	Email:
	Donation Amount:	$25 $35 $50 $100 Other
		Enter Other Amount:

	If the donation is in honor of someone special please enter the person or animal's name:

	If the donation is in memory of a loved one please enter the person or animal's name:

	Please provide the following information so we may send a card to the person or animal you are honoring or send a card to the family of the deceased:
	Name:
	Address:
	Address2:
	City:
	State:
	Zip code:
	Is there anything special about this donation we need to know?