Bainbridge – Decatur County Humane Society
Membership Application
P.O. Box 429 + Bainbridge, GA 39818
229-246-0101
DATE: ________________________
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Bainbridge – Decatur County Humane Society Membership Application P.O. Box 429 + Bainbridge, GA 39818 229-246-0101 |
DATE: ________________________ |
Name _____________________________________Address _________________________________
State ____________ Zip ______ Home Phone _________________ Email _____________________
Work Phone __________Employer _____________________________________
What kind of pets do you currently have? _________ Dogs _______ Cats _____ Other
Veterinarian _____________________
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Please check one or more areas that may be of interest to you:
_____ Membership _____ Shelter Volunteer
_____ Financial Contributions _____ Animal Rescue
_____ Fund Raising Activities _____ Foster Care
_____ Donation of Business Services _____ Board Member or Officer
_____ Newsletter _____ Other, Please specify ______________________
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Please mail your application and tax deductible contribution to the address below or you may make your donation through Paypal on the Web site at http://www.bainbridgehumanesociety.com.
Annual Membership
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Individual _____ Individual $25 _____ Family $35 _____ Junior (under 18 years of age) $10 _____ Senior Citizen (65+) $10 _____ Lifetime $1000 |
Business _____ Regular $50 _____ Bronze Paw $100 _____ Silver Paw $250 _____ Gold Paw $500 _____ Platinum $1000 |
School _____ Classroom $15
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Other Donations
In addition to memberships, we offer these options to make additional donations.
_____ Spay or Neuter a Dog - $45 _____ Provide Rabies Shot - $10
_____ Sponsor a dog or cat for adoption - $65
(provides for spay, neuter and full round of shots)