Customer Information:
Billing Address: | Shipping Address: |
Company: | | Company: | |
Name: | | Name: | |
Address: | | Address: | |
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City/State/Zip | | City/State/Zip | |
$14.00 a shirt – | Shipping | $2.00 per shirt- no shipping charge on local or pickup orders |
Order Information:
Qty | Product Description | Amount Each | Amount |
| SMALL | 14.00 | |
| MEDIUM | 14.00 | |
| LARGE | 14.00 | |
| X LARGE | 14.00 | |
| 2X | 14.00 | |
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| | Subtotal: | |
| | Tax: | |
| | Shipping: | |
| | Grand Total: | |
Notes: |
We accept checks, credit cards or Paypal This form can be mailed, faxed or emailed. |
NAME ______________________________________________________-
TELEPHONE NUMBER_________________________________________
EMAIL ADDRESS______________________________________________
CREDIT CARD NUMBER________________________________________
EXPIRATION DATE_____________________
I know that sometimes it takes more than love to save a life- my donation in the amount of $_______________will help with veterinary bills so that many animals will live a long and healthy life.
ROSES FUND FOR ANIMALS, INC.
A NON PROFIT CORPORATION UNDER TITLE 15A2-8 OF THE NEW JERSEY
DOMESTIC NON PROFIT ACT
TAX ID 26-2784508
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ROSE'S FUND FOR ANIMALS 
