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Honor Certificate Order Form
Honor Certificate Order Form
Honor a cocker spaniel lover in your life. Need to celebrate a special event, send a special thank you, or would like to memorialize a special person or pet?
Order a Cocker Spaniel Adoption Center's Honor Certificate. See our web site for examples.
The person you are honoring will receive a 5.5" x 8.5" color, certificate printed on parchment paper.
Please scroll down to answer all questions before clicking "CONTINUE".
Your Information
*
Name:
Name, please.
Max. 100 chars.
You have exceeded the maximum character count (100).
*
Phone Number:
Phone number, please
Max. 20 chars.
You have exceeded the maximum character count (20).
Email:
Recipient Mailing Information
Salutation:
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
_________ Family (Last Name of Recipient)
None
*
Full Name:
Full name, please.
Max. 250 chars.
You have exceeded the maximum character count (250).
*
Street Address:
Street address, please.
Max. 100 chars.
You have exceeded the maximum character count (100).
*
City:
City, please.
Max. 100 chars.
You have exceeded the maximum character count (100).
*
State:
State, please.
Max. 15 chars.
You have exceeded the maximum character count (15).
*
Zip Code:
Zip code, please.
Max. 15 chars.
You have exceeded the maximum character count (15).
Phone Number:
Email:
Pick the Type of Certificate:
Select between:
Celebrate
Memorial | Thank You
Christmas
Hanukkah
Customization
If you selected "Celebrate", what is the occasion you are celebrating (i.e. Birthday, Gotcha Day, Anniversary, Retirement, etc.):
If you selected "Memorial | Thank You", please select:
In Loving Memory
Thank You
*
Signature: How would you like to sign the certificate?
From:
Signature, please.
Max. 250 chars.
You have exceeded the maximum character count (250).
Name of Honoree
In honor of
*
Name (as it should appear on the certificate):
Name of honoree, please.
Max. 100 chars.
You have exceeded the maximum character count (100).
Please indicate:
Person
Pet
*
Donation Amount:
No commas or symbols
Donation amount, please.
Please enter a valid positive currency amount (no commas or symbols except decimal)
*
Date:
Required!
Method of Payment:
Check
PayPal
If you have a PayPal account, PayPal payments can be sent to:
[email protected]
.
All other credit card users can go back to the web site and submit your payment by clicking the "DONATE NOW" link or visit our Donation page.
Mail checks to:
Cocker Spaniel Adoption Center
PO Box 1704
Westminster, MD 21158-5704.
Please write "Certificate Donation" on the "For" line of your check.
Once we have received your donation, a certificate will be sent to the Honoree.
Thank you for supporting Cocker Spaniel Adoption Center. The pups are grateful.
Please click the "Continue" button below to submit your order. Thank you.
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