Animal Admirers, Friends and Donors: Register HERE!

Thanks for stopping by and registering your information on my site! This information will help me to adjust my focus to ensure I am reaching and attending to my audience of "art and animal lovers". Also, by registering here, you can become part of a team of people notified when a fundraiser, or request for assistance (in kind or financially) is needed for a local or national rescue organization. By filling out the brief form below, I will best recognize your needs/desires/donations which will allow me to focus on creating new works geared towards your likes and dislikes, or finding a recipient for your gifts. I will guard your information, and not release it to any other entity for the purpose of solicitation.

Please do not forget to be specific when offering information on the types of rescue groups and other organizations you prefer to support! Please define"which" area you are most willing to offer assistance; (donation of food, pet supplies, fencing, dog houses, etc). Add this detail in the section for comments.Thank you all for your giving and loving spirit.

For the love of all animals,

First Name	Required
Last Name	Required
Address 1
Address 2
City
State
Zip/Postal Code
E-mail Address	Required
Phone Number
Are you associated with any animal organization/group?	Yes No
Do you share your dwelling with an animal companion?	Yes   No
If Yes, What kind?	Cat Dog Fish Bird Equine Livestock Reptile Other Select All that apply
If other type pf animal please share with us. Please be specific	Other

Have you adopted an animal from a rescue group or shelter?	Yes   No
If yes, can you tell me from whom: (provide site or name and state here)
Do you have something you want to donate. Please explain. Would you be willing to make a monthly donation of food or other products to help Altanta's rescue groups? Please let me know were and how you would like to best help. Be specific. OR if you have an interesting story about an animal companion you would like to share - please do so the the space to the right:
Would you like to recognize a specific rescue group or have them added to our "Recepients" list when donations of food and other supplies are provided from Atlanta area doners? If yes, please add contact information, and web site address so we may contact them and get them enrolled in our "Receiving" program.
Name of Rescue or Organization
Address
Address
City
State
Zip Code
Contact Person
Phone Number
E-mail Address
Web Site Address
Remarks about organization

SPAMMERS, please note, this submission does not get posted to a page.

 

Questions and/or comments? Please e-mail info@liznicholas.com

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