Home > Gift-a-Vet Gift Card Donation Form

Please complete the following information if you are interested in donating gift cards through the Gift-a-Vet program:

[contact-form to=’community.support@nechv.org’ subject=’Gift-a-Vet Gift Card Inquiry’][contact-field label=’First Name’ type=’name’ required=’1’/][contact-field label=’Last Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Organization’ type=’text’/][contact-field label=’Mailing Address’ type=’text’ required=’1’/][contact-field label=’State’ type=’text’ required=’1’/][contact-field label=’City’ type=’text’ required=’1’/][contact-field label=’Zip’ type=’text’ required=’1’/]

[contact-field label=’How many gift cards would you like to donate?’ type=’text’ required=’1’/] What type(s) are you interested in donating? (check all that apply)

[contact-field label=’Major Pharmacies’ type=’checkbox’/][contact-field label=’Supermarkets’ type=’checkbox’/][contact-field label=’Major Retailers’ type=’checkbox’/][contact-field label=’T-Passes’ type=’checkbox’/]

[contact-field label=’Comment’ type=’textarea’ required=’1’/][/contact-form]