MEMBERSHIP
AND DONATION FORM

Enclosed is my contribution toward your important work on behalf of animals.

Basic Membership                             $25

Student Membership                         $10

Contributing Patron                           $50

Lifetime Membership                         $250

HAWA Lifesaving partner               $1000

Other                                                    $______

Please tell us if this gift is in memory or honor of your treasured pet(s):___________________.
Please circle below if you are interested in working on one of our committees:
Membership                Off The Wall Boutique
Fundraising                  Foster Care
Education                    Pet Adoption

Name:  ________________________________________________________
Address: _______________________________________________________
City: ______________________________________ State: ____ Zip: _______
Phone: (_____) ________-_________________
Email: _________________________________
Date: __________________________________

Please send this completed form with your Tax-deductible donation to:

Haywood Animal Welfare Association

PO Box 992

Waynesville, NC 28786

(828) 452-3751 - (828) 452-1329

THANK YOU FOR CARING