Helping Hands 4 Paws, Inc.

PO Box 232

Rindge, NH 03461

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?

______ Foster Care	_____Transportation of Animals	______Telephone Calling
______Home Visits	_____Fundraising	______ Newsletter
______Regional Contact		______Animal Evaluation
______Computer assistance/ Web Design		______Other

Sponsor (voting only): __________________________________________

Signature: ________________________________________ Date: __________

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