FORGOTTEN ANIMAL SHELTER, INC.

PO Box 46

Medina, OH 44258

I want to become a member of Forgotten Animal Shelter Inc.

I am interested in the primary objectives of this organization which are to:

  1. Raise funds to build a no-kill animal shelter to serve Northeast Ohio;

  2. Aid in the rescue and rehabilitation of abused and abandoned animals;

  3. Find foster and adoptive homes for homeless animals;

  4. Help stop the over-population of animals through spay and neuter and educational programs.

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Date                                     Birth Date

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Name

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Street Address

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City                                                  State                                     Zip Code

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Telephone Number                              E-Mail Address

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Signature

I would be interested in helping Forgotten Animal Shelter as follows:

________________________________________________________________________________

________________________________________________________________________________

Please print and complete this form and send (with applicable dues) to the address listed above. 

Please type or print legibly all information except your signature.

 

Youth (under age 16) No Dues
Adult (age 16-59) $15
Each additional family member (same address within same age category) $10
Senior Citizen (age 60 and older) $5

Dues will be billed on an annual basis covering January through December. First dues, if other than January, are to be computed at 1/12th the annual rate times the number of months remaining in current year.

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Board Approval:

_________________________________________   dated ____________

_________________________________________   dated ____________

_________________________________________   dated ____________

_________________________________________   dated ____________

_________________________________________   dated ____________

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