Northern Lights Greyhound Adoption
11247 Foley Boulevard
Coon Rapids, MN 55448
(763) 754-9754

PayPal Donation Form
(After making your on-line PayPal donation, please print, fill out, and mail this form)

Your Name

Date:

Address

City, State, Zip

Phone

Email (optional)

If your donation is in honor of a special person or pet, you may provide details here:

In honor of

For (occasion or event)

Do you wish NLGA to list this information in our newsletter and/or website?

  (circle one)                 Yes                   No

Do you wish NLGA to mail a donation acknowledgment letter?

  (circle one)                 Yes                   No

Mail acknowledgment letter to: Name

Address

City, State, Zip

If your donation is in memory of a deceased person or pet, you may provide details here:

In memory of

Do you wish NLGA to list this information in our newsletter and/or website?

  (circle one)                 Yes                   No

Do you wish NLGA to mail a donation acknowledgment letter?

  (circle one)                 Yes                   No

Mail acknowledgment letter to: Name

Address

City, State, Zip

Comments/Special Instructions:

Thank you for your PayPal donation!
Please mail this form to address at the top of the page.  Donations are tax deductible.