Please check one:
I am interested in adopting a pet, please send me an application._______________
I am a senior citizen who is not interested in adopting, but would like to become a
member. Enclosed is my $15.00 membership fee.____________________
I am not a senior but I wish to become a supporting member. Enclosed is $20..00
(single membership) or $25.00 (family).__________________________
Please accept this memorial gift in the name of (person or pet). You may send an
acknowledgement to the following address:
Name of deceased:________________________________
Pet_______ Person________ Enclosed________________
Name of person to send acknowledgment card to:____________________
Address of person to send acknowledgment to:___________________________
________________________________________________________
I do not wish to become a member at this time, but please accept my donation in the
amount of_______. Please specify if you want it to go to the general fund or the future
emergency fund:___________________
Your name:____________________________________________________________
Address:______________________________________________________________
Phone:________________________ Do you have pets now?____________________
