The Washington County Humane Society, Inc.

2011 Membership

Name ______________________________________________________________________________________

Address ____________________________________________________________________________________

City _____________________________________________  State ____________   Zip ____________________

Phone __________________________________    Email _____________________________________________
 

Yes! I want to help the animals.  Enclosed is my membership of:

q $10 Senior        q $25 Individual        q $50 Family        q $100 Corporate        q $250 Sustaining

q Other $____________

q Enclosed is my gift (Make check payable to The Washington County Humane Society.)

q I wish to charge my gift to my:    q MasterCard    q Visa
 

Credit Card Number ____________________________________________________________________

Expiration Date ______________________       Security Code (on back of card) ___________________

Name on Card ________________________________________________________________________

Signature _____________________________________________________   Date _________________

q Please send me information about leaving a lasting legacy of love to the WCHS with Planned Giving.

q SAVE A STAMP! No thank you necessary. Your work is THANKS enough!

Please mail completed form and enclosures to:
The Washington County Humane Society
3650 State Road 60
Slinger, WI   53086

Phone: 262-677-4388 | Fax: 262-677-0388 | E-mail: admin@washingtoncountyhumane.org