Membership Form - Upper Credit Humane Society

Is this a new membership or renewal? *

New
Renewal

Active membership: $25/year
Includes one (1) vote at the Annual General Meeting, 10% discount on adoption fees, members-only access to the website.

Family membership: $45/year
Includes two (2) votes at the Annual General Meeting, 10% discount on adoption fees, members-only access to the website.

Junior membership: $10/year
Must be seventeen (17) years of age or younger, 10% discount on adoptions, members-only access to the website

Type of Membership *

Active
Family
Junior Choice

per year

I would also like to make a donation in the following amount

$

How did you hear about our membership program? *

I adopted from the Upper Credit Humane Society
Through the Upper Credit Humane Society website
Other

If other, please specify here

Name(s) *

If multiple, one per line

Address *

Street Address Address Line 2 City Province Postal Code

Email *

I will pay by *

Cash
Cheque (payable to UCHS)
Online (PayPal, Debit/Credit)

Payment is e-transfer (chair@uppercredit.com), via PayPal to donationsonline@uppercredit.com or by credit card.

Decline public recognition

I would not like to be publicly recognized

Please check here if you DO NOT want your name to appear in any public recognition of Upper Credit Humane Society’s members and donors.

Active Volunteer

I am an active volunteer

Contact Preference *

Email
Post
I do not wish to be contacted

Total

$ 0.00 CAD

Payment Method *

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name