Adoption Renewal Form
I would like to renew my adoption of:
Renewal amount: $
The Adoptive Party
Name that adoption is currently under:
Address:
Apt/Suite/Floor:
City:
State or Province:
Zip:
Country:
Telephone:
Ship Adoption Certificate and Package to above address.
Please provide an email address to receive an online acknowledgment of your renewal.
E-mail Address:
Please retype your email address:
You may contact me by email.
Please do NOT contact me by email.
Is this adoption being made for someone else?
If yes, please fill out the following information.
If no, please go to Special Instructions and Payment >>
In memory of:
In honor of:
Special Occasion (birthday, anniversary, etc.):
Message to be printed on card:
Your relationship to recipient:
Name of recipient:
Recipient's email:
Recipient's address ( if different from your own):
Address::
Apt/Suite/Floor:
City:
State or Province:
Zip:
Country:
Telephone:
Ship Adoption Certificate and Package to above address.
Recognition Gift
All renewals will receive an adoption certificate, tax deductible receipt and ONE of the following gifts (please select only ONE):
The Quake and the Wolong Pandas
, by Suzanne Braden
T Shirt Size:
Select a size >>
Small
Medium
Large
X Large
XX Large
If you have a design preference, state here:
Mom and Cub Plush Toy
No gift, please use all of the money to support my panda.
Payment Information
Payment Type:
Personal Check
Company/Organization Check
Credit Card
Please enter your name and account number exactly as they appear on your credit card.
Name as it appears
on credit card:
Credit Card
Information:
Type:
Visa
MasterCard
Acct. #:
Expiration Date: Month/Year
Signature as it appears on your credit card
(sign only if you are printing and mailing this form)
:
Please include any special instructions you may have regarding
your adoption in the space provided below.
Special Instructions or Comments:
Thank you for your generous support!
All donations to Pandas International are tax deductible in accordance with the IRS.
Pandas International does not share, rent or give out names of our donors to any other organizations.
Click here for our privacy policy