Wolves Ontario! Donation Form

YES! I want to adopt a wolf to help save Ontario's wild wolves.
Please mail this form with appropriate payment method to: Earthroots - Wolf Adoption Request 401 Richmond St. West, Suite 410 Toronto, Ontario M5V 3A8
Here's my donation of:	Wolf Pup Protection ($50) Alpha Wolf Protection ($75) - KIDS or ADULTS Wolf Pack Protection ($100)
	I would prefer to give $_________

Billed to:

Name ___________________________

Address ___________________________

Province ___________________________

Postal Code ___________________________

Telephone# ___________________________

E-Mail
Address ___________________________

Shipping address (if different from above)

Name ___________________________

Address ___________________________

Province ___________________________

Postal Code ___________________________

Telephone# ___________________________

E-Mail
Address ___________________________

Please Check One:

I have enclosed my cheque
I prefer to pay by VISA MasterCard
Card #	___________________________
Expiry	___________________________
Signature	___________________________

I want to donate to Earthroots Coalition in full
support of all campaigns. I understand this
contribution is not tax deductible.

I require a tax receipt and want to donate to
Earthroots Fund (charitable registration
#135165140 RR0001).