Donate form for the Upper Michigan Dog Therapy Partnership

The Upper Michigan Dog Therapy Partnership Donation Form
(Tax deductable Donations)

Please print, fill out and return to:
Upper Michigan Rehabilitation Center
Upper Michigan Dog Therapy Partnership
Attention: Brad Jackson, MSPT
580 W. College Ave.
Marquette, MI 49855

Amount $_____________________________________
Your Name____________________________________
Your Address ____________________________________ ____________________________________ ____________________________________
Your Phone Number____________________________________
Can we call to thank you?	YES_______ NO________
Would you like us to mail you a receipt?	YES_______ NO________
Date	______________________

Upper Michigan Dog Therapy Partnership!