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Veterinary Care Foundation, Inc
Membership Application
Practice Name
*
Practice Logo (If any)
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Address
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Zip
*
Phone
Email
*
Website
Referred by DRS
Member of VEG(Veterinary Emergency Group)
Member of Compassion Group
Member of Suveto
*
Indicates required field
Having received payment of annual membership fee of $480, the Veterinary Care Foundation, a 501 (c) (3) charitable foundation, will create a charitable fund for the practice at left under it's charitable umbrella.
Additionally, the Veterinary Care Foundation agrees to provide veterinary practice with:
- Foundation Brochures
- Sample letter to practice clients
- Website and support (allowing electronic donation of funds)
- Member electronic access to fund balance
- Gift acknowledgement to donors for gifts $250 and above, per IRS regulations, and electronic notification to practices for all online gifts
Dues will be renewable annually on the member’s initial application date and may be paid online, by mailing a check or by phone. If member dues are not received by renewal date, account will continue to allow donations on member’s behalf, however they will not be allowed to submit Grant Requests. Once a member has exceeded 60 days past their due date, their account login will be deactivated until brought current of all past annual dues owed to the Veterinary Care Foundation, Inc.
Authorized Representative:
User Name
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(Choose your User Name carefully! They are permanent and cannot be changed.)
Password
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Confirm Password
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Billing Information
Address
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City
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State
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Zip
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Name on Card
*
Card Number
*
Month
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Year
*
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Card CVC
*
Mailing a check
*
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When the form is complete, you have two choices: