The Humane Society of Louisiana

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Please fill out the form below to donate to the Humane Society of Louisiana.
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HUMANE SOCIETY OF LOUISIANA
DONATION FORM

I'd like to make a special tribute donation in honor of:
Please acknowledge this gift to:
OR Send the acknowledgement by EMAIL to:
Please charge my credit card $
Disclose the amount given by you to the receipient?
YES:
NO: (The recipient will receive a card stating: "A Generous Donation has been made in your name."
Special message or instructions:

BILLING INFORMATION:

FIRST NAME:

LAST NAME:

EMAIL ADDRESS:

HOME ADDRESS:

CITY:

STATE:

ZIP:

HOME PHONE:

CREDIT CARD NUMBER:

EXPIRATION DATE:

Month:

Year:

3 or 4 Digit Security Code

Checks can be made payable to:
Humane Society of Louisiana
and sent to
PO Box 740321, New Orleans, LA 70174

We can also take your credit card donation by
phone. Please reach us at 1-888-6-HUMANE.

Your donation will be billed to your credit card as HUMANE SOCIETY OF LOUISIANA

Our agency is a 501(c)3 nonprofit organization.
All donations are tax deductible to the fullest extent allowed by law.
Our Federal ID number is 58-1795272.