Buy and Donate Program Application

Your Name *

First

Last

Title *

Your Rescue Group's Name *

Is your group located in the United States?

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Confirm Email

Is your group's PayPal email the same as this email address?

We need your PayPal email address to send our donation. If you don't have it, you can sign up for free at paypal.com

Your Website / URL *

If you don't have a website, please enter your Facebook page's URL

Facebook Link

Instagram Link

Please confirm that your application is on behalf of a registered non-profit animal rescue group *

File Upload: Documents to prove non-profit designation *

Click or drag files to this area to upload.You can upload up to 5 files.

Please send a copy of your 501(c)3 certificate, or an equivalent document, to prove your non-profit designation

Acknowledgement *

By submitting this form, I acknowledge that the information provided above is accurate and truthful to the best of my knowledge