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P O Box 190 Road Town, Tortola British Virgin Islands
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MEMBERSHIP FORM
Please print this form out and send it to the above address with your payment or donation.
Membership year is Jan 1st - Dec 31st
Name: ____________________________________________________________
Address __________________________________________________________ ___________________________________________________________________
Telephone: Home ___________________ Work __________________________Fax ____________________
email ______________________________________
Membership for the Year 2010
__/ Renewal___ ______ __/ New
__/ Standard ($75)__ __ __/ Corporate ($250)
__/ Sponsor ($150)__.....___ __/ Donation
($___________)
Please return this form with above information completed so that we can update our data base, and enclosing your cheque for the relevant amount, made payable to The Humane Society of BVI
Amount enclosed _________________ Date ________________________
Membership fees assist with the ever increasing overhead expenses of running the animal shelter.