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The Humane Society of Southeast Texas
Membership / Contribution
Enclosed is my contribution of $ ___________________________________________
Name:_______________________________________________________________________
Address:____________________________________________________________________
City:__________________________________________ State:_______ Zip:__________
[ ] Family or Single: $20.00 annually
[ ] Junior (under 18): $4.00 annually
[ ] Sustaining: $50.00 or more annually
[ ] Patron: $100.00 or more annually
[ ] Sponsor: $250.00 annually
[ ] Benefactor: $500.00 annually
............................................................................
[ ] Memorial Gift
Name of Person
to be remembered:_____________________________________________________
Name of Pet
to be remembered:_____________________________________________________
[ ] Honorary Gift
Name of Person
to be honored:________________________________________________________
Name of Pet
to be honored:________________________________________________________
[ ] Gift of Love
............................................................................
[ ] Please send
acknowledgment to:____________________________________________________
at:____________________________________________________
All donations and memberships are tax deductible. Your cancelled check will be your receipt.
To save money receipts are not issued unless specifically requested. Please mail this form with your check to:
The Humane Society of Southeast Texas |