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Membership Type: Voting $30.00_________ Non Voting $10.00: _____________
Name: _________________________________________________________
Address: _______________________________________________________ State: ____ Zip: __________
Phone Day ( ___ ) ___-_____ Phone Evening: (___) ___-_____ Email: _________________________
Rescue or Shelter affiliation: ______________________________________________
Address: ________________________________________________________ State: _______
Phone: (___) ____-_____ Web site: _______________________________________________________
Have you ever been a past or present officer or on the board of a Rescue or Shelter (please specify): ________________________________________________________________________________
Are you willing to serve as an officer or on the board of HH4P in the future: Y / N
Would you consider volunteering for our Organization? ____ Yes ____ No
If yes in which of
the following areas?
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______ Foster Care
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_____Transportation of Animals
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______Telephone Calling
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______Home Visits
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_____Fundraising
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______ Newsletter
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______Regional Contact
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______Animal Evaluation
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______Computer assistance/ Web Design
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______Other
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Sponsor (voting only): __________________________________________
Signature: ________________________________________ Date: __________
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