To honor the memory of a beloved pet, please fill out the Pet Memorial Program Enrollment Form below. We ask for a minimum of $100.00 donation for each pet you wish to honor, and upon our receipt of your check and the completed form, we will post the name of the pet on our Pet Heaven page.

A Note to Veterinarians:
As a veterinarian, you may already make contributions to veterinary institutions and/or humane organizations in memory of clients' pets. NY SAVE has instituted a similar program to support its mission of funding the costs of emergency care for pets whose owners are unable to pay such costs themselves. Taking part in this program is a special way for you to show that you share your clients' grief over the loss of beloved pets. And through these memorial gifts, remembered pets will act as guardian angels to other companion animals in need of veterinary care.

Your first pet memorial gift will enroll you in our Pet Memorial Program. We ask for a minimum of $10.00 for each pet you wish to honor. Upon our receipt of your check and the completed form below, we will send an acknowledgment to your clients letting them know that you've made a contribution in memory of their pets. We will also send you a supply of NY SAVE Pet Memorial Transmittal forms for your future use.

NY SAVE Pet Memorial Program Enrollment Form

Your Name:

____________________________________________________________

Address:
(Please include city, state, and zip code. If veterinarian, please give hospital name and address.)

____________________________________________________________

____________________________________________________________

____________________________________________________________

Enclosed is a gift of $ _________ Check: ____ or Credit Card: ____

Credit Card # ______________________________ Expiration date: ____________

In memory of: (pet's name) _______________________________________

Dog: ____ Cat: ____ Other: ________________________

If you have any questions, please feel free to call NY SAVE at (212) 246-3097 or
contact us by e-mail.

Please mail the completed form to:

NY SAVE Pet Memorial Program
331 West 57th Street, Suite 293
New York, NY 10019-3101