Page 64 - Executive Director
P. 64
8012 - Rescue League/Shelter Agreement
Name of
Organization:___________________________________________________________________
______
President’s Name:________________________________ Vice
President:________________________________
Treasurer’s Name:_____________________________
Billing Address:_______________________________________________________________
_______________________________________________________________
Organization Phone
Number:_________________________________________________________
(Please give us a number which we can refer clients to in the event that they are looking for a new companion)
Organization Fax
Number:___________________________________________________________
(This number would be utilized for invoices, records, and/or receipts as needed.)
Organization
Website:_______________________________________________________________
(We would like to add your web address on our website to inform our clients of the groups we sponsor)
Primary Contact to authorize medical treatment or
services:__________________________________
Phone Number:______________________________________
E-mail:______________________________________________
Alternate Contact to authorize medical treatment or
services:_________________________________
Phone Number:______________________________________
E-mail:______________________________________________
Media Release:
Keep an eye out for your pets to be featured on pour website and Facebook page. Thank you
for being a part of the Legacy Veterinary Hospital family. We truly care about you and your
pets and look forward to communicating with you and sharing your pets stories with our
community throughout the year.
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