How You Can Help Intermountain Therapy Animals

If you are able to help us make a difference, please print this form and send it to Intermountain Therapy Animals via facsimile or mail it to:

    Intermountain Therapy Animals
    P.O. Box 17201
    Salt Lake City, Utah 84117

Telephone:	801-272-3439
Fax:	801-272-3470

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Yes—I want to make a paws-itive difference. Here is my donation.

$250 $100 $50 $35 $25 other

First Name:
Last Name:
Email Address:
Street Address:
City:
State/Province:
Zip/Postal Code:
Voice Phone:
FAX Phone:
Payment method:	credit card check enclosed
Credit Card Type:
Credit card #:
Expiration date:
Signature:


I would like information about:
joining ITA as a supporting member becoming a Pet Partner^®

We enjoy making presentations about our work to companies, clubs and organizations throughout Utah. Please call 801-272-3439 if you are interested.
Donations-in-kind are also welcome. Intermountain Therapy Animals is a registered Utah charitable non-profit organization. Your donation is tax-deductible to the full extent of the law.

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