Please enter your information below:

NameAddressCityState / ZipHome PhoneWork PhoneEmailI would like my donation to be placed in one of the following program funds (check one):2nd Chance Medical
Spay/NeuterI would like my tile to have a (check one):Paw Print Silhouette
I will go to the store with my pet to make a paw printPick a paw print colorI would like my tile to say (check one):In Honor of...
In Memory of...
Name OnlyName of Pet or PersonPlease make checks payable to "City of Charlotte". In the memo line write "Animal Control" and specify which fund you are donating to.

Send payments to: Animal Care & Control, c/o Melissa Knicely, 8315 Byrum Dr, Charlotte, NC 28217

If this is a gift and you wish to have an acknowledgement sent please include the recipient's name and address below.

Recipient's NameRecipient's Address