Adopt-A-Killer-Whale Form | Dolphin Research

EA_0002 Split Fin

An Adopt-A-Killer-Whale membership makes a great present. If you choose that option we will ask some questions about how you would like this treated. If you choose to have a pack mailed we will include an A4 printed certificate and a dolphin money box (great for children).

Dolphin Research Institute is a charity registered with the ACNC. The $98 annual membership is treated as a tax-deductible gift.

Your Adoption Details(Required)

For Myself

For a Gift

Please don't worry if you or the recipient of your gift, relies on or prefers to receive things by mail. Just provide the details and we will send it out.

Do you wish to have a membership pack mailed or main items sent as an email?(Required)

Please only send membership materials that can be emailed.

Please mail a membership pack ($27 added for items & postage (over $35 value)).

This includes mailing to a gift recipient

Name(Required)

Title First Last

Email(Required)

Mobile(Required)

Landline

Address (if you wish us to mail a physical pack to you)(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Do you want the pack to be sent to you or the recipient?(Required)

To me

The recipient

This will be via post if you selected to mail the pack above.

Name of your recipient(Required)

Title First Last

Email of recipient(Required)

Phone

Address of recipient (For mailing snapshot news)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your relationship to the recipient?

Helpful for communication if we send a pack from "Grandma" directly to recipient (for example)

Recipient's date of birth (Helps to chose pack contents)

We invite Adopt members to renew their support on the 12-month anniversary. Would you like this to be sent to:

To me

The recipient

By default, we will send the invitation to the giver.

Adopt-A-Whale

Price:

Merchandise Pack and Postage (Over $35 value)

I wish to make an additional donation of

None

$10

$20

$50

How did you hear about the program?

Total

Dear supporter, when you select "submit" you will be transferred to PayPal. You will have an option to use your own card, without having a PayPal account. We use this process to ensure the security of your transaction.

Payment Method

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

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EA_0002 Split Fin

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