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Ownerís Name:

††††††††††††††††††††††††† (as you would like it to appear on the ornament)

 

Please give us your petís name(s) and tell us whether it is a cat or dog so we can personalize your ornament.

 

Petís Name†† †††††††††† †††††††††† †††††††††† †††††††††† Cat or Dog (or whatever?)

 

†††††††††††††††††††††††††††††††††††††††††††††††††††††† /

††††††††††††††††††††††††††††††††††††††††††††††††††††††

†††††††††††††††††††††††††††††††††††††††††††††††††††††† /

†††††††††††††††††††††††††††††††††††††††††††††††††††††††

†††††††††††††††††††††††††††††††††††††††††††††††††††††† /

††

††††††††††††† Amount ($5.00 per name)

 

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††††††††††††††††††††† I would like to become a donor

 

†††††† Address

 

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†††††† †††††††††††Yes, I want to become a CCLAS member!Enclosed are my annual membership dues.

††††††††††††††††††††† ††††††††††††$10.00 Individual††††††††† Name:

†††††††††††††††††††††

††††††††††††††††††††† ††††††††††††$6.00 Student††††††††††††† Address:

 

†††††† Total amount enclosed:†††††††††††††††††††††††††††††††††††††††††††† Phone:

 

 

†† Please make checks payable to: CCLAS

††††††††††††††††††††††††††††††††††††††††††††††††††††† P.O Box 771323

††††††††††††††††††††††††††††††††††††††††††††††††††††† Lakewood, Ohio44107