CPCRN - Tag Program

Giving a Tag as a Gift

Please fill out the following information about you and the person receiving the gift.

Due to the amount of personal information that is needed in order to enroll in the Col. Potter Tag Program, and decisions that need to be made, the recipient of your wonderful gift will have to come back to the this site to fill out the necessary forms and agreements.

NOTE: When providing us with the recipient's information, you must make sure that the name you give is the one that the recipient uses when filling out the enrollment form on the website. Otherwise we may not be able to determine if the item they enroll for has been paid.

The TAG PROGRAM will provide then with the tag and a one year membership in the tag registration service. After the year is up, their membership in the tag registration service IS AUTOMATICALLY RENEWED ANNUALLY BY CPCRN AT NO ADDITIONAL COST TO YOU, FOR THE LIFE OF THEIR PET.

* Required field

Giver's Name*

First*	Last*

Enter your name not the name of the person receiving the gift.

Giver's Address*

City	State/Province

Zip/Postal Code

Enter your address not that of the person receiving the gift.

Giver's E-mail*

Enter your email address not that of the person receiving the gift.

Recipient's Name*

First*	Last*

Number of Tags*

Payment Method* Check PayPal