SPONSORSHIP REGISTRATION FORM
ANIMAL ADOPTION PROGRAM

SPONSOR INFO:
FIRST NAME ............................................................................................................
LAST NAME ............................................................................................................
COMPANY ...........................................................................................................
ADDRESS ...........................................................................................................
CITY ....................................................................POSTAL CODE...................
PHONE ....................................................................FAX ...................................
E-MAIL ...............................................................................................................

AGE (If under 19)

...............................................................................................................

RECIPIENT INFO:         (If this is a gift for someone please fill following information)
FIRST NAME ...........................................................................................................
LAST NAME ...........................................................................................................
ADDRESS ............................................................................................................
CITY ....................................................................POSTAL CODE...................
PHONE ....................................................................FAX ...................................
E-MAIL ...........................................................................................................
Please send it to: ME RECIPIENT

SPONSORSHIP DETAILS

I WOULD LIKE TO SPONSOR A (ENTER A SPECIES HERE ) .....................................................................

 IN (ENTER NUMBER OF UNITS) ..................................... SHARED SPONSORSHIP UNITS OF $25.00 EACH

 OR WHOLE SPONSORSHIP AT $............................. DATE (TO BE PRINTED ON CERTIFICATE)....................
   SIGNATURE .............................................................DATE.................................................................

Payment details:

 CASH CHEQUE VISA

Please make cheques payable to:       PAPANACK PARK ZOO


VISA INFORMATION:
NAME ON VISA ...............................................................................................................
CARD NUMBER ...............................................................................................................
EXPIRY DATE ..................................................SIGNATURE..........................................
  Mail to:  150, County Road 19, Wendover, Ontario, K0A 3K0 E-mail:    info@papanack.com
  Fax:        1 - (613)  673 - 5870 Phone:    1 - (613)  673 - 7275