Name ______________________________

Address ____________________________

City __________________ State _____ Zip __________

$10 _____ $25_____ $50_____ $100____ Other_____

[ ] Please contact me about volunteer opportunities.
[ ] Please save postal costs for the animals. I do not wish to receive a thank you.

Call 585-0517 with questions.

*Official registration and financial information of
the Humane Society of Lackawanna County
may be obtained by calling the Dept of State
by calling 1-800-732-0999. Registration does not imply endorsement.