AMERICAN BELGIAN MALINOIS CLUB CHARITABLE TRUST
				A 501(c)(3) ORGANIZATION
	  (this contribution form must be printed and mailed, see address below)



___ I would like to help sponsor the treatment of ______________ (fill in dog's name).

  
		    Here is my $___________ contribution to help cover the 
			       special treatment of _______ (fill in dog's name) needs.


		      My contribution is in (circle one) memory/honor of: 

	__________________________________________________________________________


If you would like us to notify anyone of your gift please provide the 
following information: 

Name of person to be notified: _____________________________________________

Full Mailing Address:_______________________________________________________

Relationship to Person, Pet or Occasion Noted Above:________________________


Your Name: ____________________________________________________________________

Address: _________________________________________________________________

__________________________________________________________________________

City: _________________________________  State: _________________

Zip Code: ____________________________________

Phone: ____________________________________  E-Mail:____________________________


____ I prefer to remain anonymous in any recognition listing (Check if Yes) 


Please accept the sincere thanks of everyone involved with ABMC Rescue. 
Your donation will help ensure that Malinois continue to be rescued, fostered 
and adopted, enriching multiple lives along the way.

Please make checks payable to : ABMC Rescue Fund

Please fill in the dog's name in the address below to insure it is credited to the correct dog.
Mail checks to : 


ABMC Charitable Trust - Rescue Fund
Attn: __________ Treatment 
c/o Jim Moses
21710 Cove Point Farm Road
Tilghman Island, MD 21671



Your contribution is tax deductible to the extent permitted by law. Be sure 
to retain retain a copy of this form and your check for your records.