STEP 1: SPONSORSHIP APPLICATION FORM

(Please Print Clearly if you print, fill out and mail form)

First Name                                    Last Name       

Address                                        City                   

State or Province                        Country               

Zip                                                Phone               

Email                       

Is this a gift?            Yes    No   

If yes, please provide the name and address of the gift recipient (which will appear on certificate):

First Name                                    Last Name       

Address                                        City                   

State or Province                         Country            

Zip                                                 Phone               

Email                   

Where would you like adoption package sent?    you    gift recipient

Animal to be sponsored:       

Or Park Bench ($5,000.00)     Primate or Bird Habitat (min. $5,000.00)        Large Animal Habitat (min. $25,000.00)

Annual sponsorship fee:    $75.00 $150.00 $250.00 $5,000.00 $25,000.00     

You may print this form and send the completed form along with the appropriate payment to:

Keepers of the Wild

13441 E. Hwy 66

Valentine, AZ 86437

ATTN: Sponsorships

OR you can submit this form on-line and pay using the safe and secure PayPal payment option.

Your sponsorship package, including the official sponsorship card, will be mailed to you.  Please

allow 3 weeks for delivery.  Donations are tax-deductible, as permitted by law.  Your donation will

help to feed, house and care for "your animal(s)" and that "your animal(s)" will continue to reside

at Keepers of the Wild.