Print, fill-in, and mail this form with a check or credit card information to:
Helping Paws
P.O. Box 634
Hopkins, MN  55343

If you have any questions, please call us at 952-988-9359

SHIPPING INFORMATION

Name:____________________________________________________

Organization: ______________________________________________

Address: _________________________________________________

_________________________________________________________

City, State, Zip: _____________________________________________

Day-Time Phone Number: _____________________________________

METHOD OF PAYMENT:

Check Enclosed: ______ (U.S. Dollars Only, Payable to Helping Paws)

Credit Card: _______ Type (please circle): VISA or MASTERCARD

Credit Card #: _______________________________________________

Expiration Date: ______________________________________________

Signature: __________________________________________________

Credit Card Billing Address: _____________________________________

___________________________________________________________

City, State, and Zip Code: _______________________________________