NISRA Rescue Calendar Donation via CHeck

NISRA Rescue Calendar Donation via Check

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Name

First

Last

Shipping Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Calendar(s)

Please indicate the number of calendars you wish to purchase:

Cost of each calendar = US $20

Total Cost for Calendar(s):

Price: $0.00

Shipping

Please indicate where the Calendar(s) will be shipped:

US address
International address

Additional Donation?

If you would like to make an additional Donation to NISRA please indicate the amount below in US $:

Check Total:

Total Summary:

Item Quantity Total

There are no products selected.

Total Cost for Calendar(s): 1 $0.00

If you would like to make an additional Donation to NISRA please indicate the amount below in US $: 1 $0.00

Shipping Fee - US Customers - 1 - 6 Calendars 1 $10.00

Shipping Fee - US Customers - 7 - 20 Calendars 1 $13.00

Shipping Fee - US Customers - Ship with Complimentary Calendar 1 $0.00

Please enter the International Shipping Fee in US $ (as determined by Elaine) 1 $0.00

Total $0.00

Donor List Entry

May we include your name (or your kennel name, In Memory of, etc.) on the NISRA website donor list?

No, I wish to remain anonymous
Yes, you have permission to include a name of my choosing on the NISRA website donor list

Privacy & Security

Privacy Policy Confirmation
Ticking this box and submitting this form, you confirm that you understand the following:

This form collects your name, email address, phone number and other personal information to allow us to communicate with you now and in the future. For more information please see our Privacy Policy.

Yes, I understand

Confirmed Payment