Rottweiler Health Foundation - General Donation Form

please check all that apply:

I/we enclose a donation of $____________ to support Rottweiler health research.

I/we would like to pledge a contribution of $ ________ for every puppy that I/we sell and/or every stud fee that I/we collect, in addition to the donation above.

Name(s):

_______________________________________________________

Address:

_______________________________________________________

City/State/Zip:

_______________________________________________________

Telephone:

____________________________ Email: _____________________

Signature(s):

_______________________________________________________

My check payable to the Rottweiler Health Foundation is enclosed.

Please charge my:

Visa

Mastercard

Credit card number	____________________________
Expiration	________
Cardholder's Name	____________________________
Cardholder's Signature	____________________________

Please send the completed membership application and dues made payable to the Rottweiler Health Foundation to:

Teresa Bradley
Rottweiler Health Foundation
16139 NE Boutelle Road
Battle Ground, WA 98604-9759

	Rottweiler Health Foundation General Donation Form FUNDING HEALTH RESEARCH