Become a Constant Companion

Please use this form to make a continuing monthly donation to support the homeless animals in our care. For other types of giving, please click on the appropriate link below:

***PLEASE NOTE: All the information must be completed in this form in order to submit.***.

Donor Contact Information

Title(s) :
First Name(s) : *
Last Name(s) : *
Street Address: *
City: *
State: *
ZIP: * xxxxx--xx
Phone Number: * - - xxx-xxx-xxxx
Email Address: *

Donation Amount

Donate to: *
General Fund Help Me Heal Fund
Four Lakes Wildlife Center Feline Friends Fund
Humane Education Equine and Wildlife Barn Remodel
Spay/Neuter Fund Other
Amount: *
Other $ ($5 minimum)

Credit Card Information

Card Type: *
Card Number: *
Card Expiration: *   
Security Code: *
Name on Card: *
Amount: * $
Please check here if you do not want your donation published.

You can expect an emailed receipt for tax purposes. If you have questions regarding donations, please contact [email protected] or (608) 838-0413.
Please answer the security Question:  What is 2 + 4 = ?