Siouxland Humane Society - Printable Donation Form

The Siouxland Humane Society, established in 1889, is a not-for-profit organization supported solely by private donations, with no United Way funds or governmental monies. We exist to provide services and programs that promote the humane treatment of animals in the Siouxland area.

Please complete this form, then print and mail with a check or credit card information to:

Siouxland Humane Society
1015 Tri-View Avenue
Sioux City, IA 51103

Your compassion and assistance are vitally important.

Last Name:
First Name:
Street:
City:	State: Zip:
Phone:
Email Address:

YES! I would like to help the Siouxland Humane Society continue meeting the needs of Siouxland’s abandoned and unwanted animals.

Enclosed is my tax-deductible contribution of:

	$1,000 or more		$250		$50		Other
	$500		$100		$25

Please Bill My:

Visa MasterCard

Card Number:

Expiration Date:

Signature:

_________________________________________________________________________

Please designate
my donation:

In Memory of
	Person	Pet

In Honor of
	Person	Pet

Please notify:

Your gift will be acknowledged to the person or family you designate below.

Name:

Street:

City:

State:

Zip:

Phone:

Make your tax-deductible check payable to: Siouxland Humane Society

Please consult with a licensed attorney about remembering the Siouxland Humane Society in your will/estate planning.