Membership/Donation Form
[annual members fees information updated August 15, 2014]

Yes, I would like to become a member of Bond County Humane Society:

_____ $1,000.00 Lifetime
_____ $100.00 Corporation / Organization
_____ $50.00 Family
_____ $30.00 Individual
_____ $15.00 Senior (60 and older) / High School or College Student
_____ Other (Donation only, non-member)
_____ Sponsor-A-Pet Donation: $____One-Time $____Monthly $____Annual.
          Sponsored Pet's Name ___________________.

Name: _________________________________

Address: ________________________________________

City: _________________________ State: _________ Zip Code: _________

Home Phone: (____)________________ Work Phone (____)_________________

Email Address: ________________________

Donations make a wonderful memorial gift. If you wish your donation to be a memorial,
please fill out the information below.

This donation is given in memory of: _______________________________

Recipient Address: _______________________________________________

In memory of : _____Cat _____Dog _____Person _____Other (i.e., bird, lizard)

_____ Yes, I would like my donation/memorial to be displayed on a donation/memorial plaque.

_____ Yes, I would like to be added to the Bond County Humane Society mailing list.

_____ Yes, I would like to receive BCHS newsletters, event notifications and other materials via email.

_____ Yes, I would like to be a foster home.

_____ Yes, I would like to be a volunteer.


Please mail check or money order payable to: Bond County Humane Society

Bond County Humane Society
1403 South Fourth Street
Greenville, IL 62246