| Name:______________________________________ |
Date:___________________________________ |
| Address:_______________________________________________________________________________ |
| Home phone #________________________________ |
Work phone #____________________________ |
| MEMBERSHIP CATEGORY AND ANNUAL DUES: |
| __________$15 Individual |
__________$25 Business (nonvoting) |
| __________$ 25 Family |
__________$200 Lifetime Member |
| __________$__________Donation |
__________$1 Under 18 (nonvoting) |
| __________ Yes, I am willing to help with: |
|
| __________ Fostering Puppies/Kittens |
| __________ Fostering sick or injured animals |
| __________ Working with animals at the shelter |
| __________ Fundraising activities |
| __________ Other |
| __________ Regrettably, my schedule doesn't allow me to volunteer. |
| Comments or suggestions:
|