Columbia County Humane Society

Honorariums and Memorials

If you would like to honor or memorialize a loved one or a pet, please fill out the following information.

Your Name:________________________________
Address:________________________________
City/State/Zip:________________________________

Please Check: ________ In Honor________ In Memory
Amount Enclosed: $________

Name of Person or Pet to be Recognized:_______________________________

Occasion (if applicable):_______________________________

If you would like a card sent to the family of the person or pet to let them know that you gave a memorial, please provide an address:_______________________________

Please make checks payable to: CCHS. Thank you!

Mail to:

CCHS Honorarium/Memorial
N7768 Industrial Road
Portage, WI 53901-0035