Pre-Order Program
Start-up Packet Request Form
Call (800) 859-5170 or Fax to (574) 234-2047

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.
850 Marietta Street, Suite 200, P.O. Box 4400
South Bend, IN  46634  USA
(800) 859-5170     (574) 234-2144    Fax (574) 234-2047
www.WorthyCauseFundraising.com