Pre-Order Program
Start-up Packet Request Form
Call (800) 859-5170 or Fax to (574) 234-1318

Date:  ___________________      

Organization:       ______________________________________________________________________

Contact Person:  _________________________________  Phone:  ______________________________

E-mail Address:  ___________________________________  Fax:  ______________________________

Shipping    Street:  ______________________________________________________________________
Address                             
City:  ______________________________  State: ______  Zip Code:  ______________________



# of Packets Requested:  _______________ (one per student / club member)

Individual Packet Includes:
Triplicate Order Form / Product Detail Sheet
(pictures, pricing and information about all products)

Money Collection Envelope
Worthy Cause Fundraising Pet Products, Ltd.
141 East Cripe Street
South Bend, IN  46637  USA
(800) 859-5170   Fax (574) 234-1318
www.WorthyCauseFundraising.com
Email:  WorthyCausePet@att.net
®