Name:_____________________________________________________

Address: __________________________________________________________

City, State, Zip: _____________________________________________________

Phone #: __________________________________________________________
Fax #: ____________________________________________________________

Email Address: _____________________________________________________

We would like to contribute $_______________ to the Walk.

Please contact me about forming a Bark a thon Walk Team.
Please return this form:
Bark a thon Walk at Wampatuck State Park on May 7th, 2006 Or send your contribution directly to:
Friends of the Scituate Animal Shelter
P.O. Box 823
Scituate, MA 02066

Please call or email for pledge materials.
For more information, contact William Hall, 781 749 4492 or William@gailhall.com