Humane Society of Wilkes

Application for Membership

Please print and fill out the following form to become a member of the Humane Society of Wilkes. Adult dues are $15.00 per year, and youth dues (12 years old or younger) are $10.00 per year. Return this form with your check or money order to: (Do NOT send cash through the mail)
	Humane Society of Wilkes P.O. Box 306 N. Wilkesboro, NC 28659
If you have further questions about the Humane Society of Wilkes membership, you may contact us at 336-838-9588 or e-mail us here

Date ____________________ Adult $15.00 _______ Youth $10.00 _______

Name ________________________________________________________

Mailing address ________________________________________________

City, State, Zip Code ____________________________________________

Home Phone _____________________ Work Phone ___________________

E-mail address_____________________ Fax Number ___________________

Occupation (optional)____________________________________________

I am interested in helping in the following areas:
Volunteer at an Event Provide light refreshments for meetings Provide foster home for pet Sponsor KIND News for classroom Make crafts or baked goods for fundraising events Participate in programs for schools, or civic groups Post copies of newsletter at work, school or church	Fund Raising Membership Newsletter Public relations Assist with adoption fair Finance Education
I have the following special talents or experience that could help the Humane Society of Wilkes:
________________________________________________________________________________
________________________________________________________________________________
In addition to my dues, please accept my tax-deductible contribution in the amount of $___________