Please select print, and then mail with check payable to HSEC (Home Sponsoring)
Name:__________________________________Date:_____________
Address:_________________________________Check if this is an address change
City:____________________________________ State:_______Zip:________
E-Mail:___________________________________
Phone:(Home) ___________________________ (Work) ___________________________
I WOULD LIKE TO BECOME A MEMBER OF HSEC
Individual -ONLY $10 per year Family-$15 per year
Lifetime-$500(Name engraved on plaque)
I WOULD LIKE TO MAKE A DONATION to the General Fund of $________
I WOULD LIKE TO SUPPORT SPAY/NEUTER PROGRAM with (circle one) MONTHLY, QUARTERLY, YEARLY tax deductible donation in the amount of $__________ Please send me a reminder!
I WOULD LIKE TO HONOR(#)______PETS ON THE CHERISHED FRIENDS WALL.
Office Wall- $50(up to 2 pets per space) Kennel Wall-$25 for each pet/space
Pet's Name:_______________________________Description:__________________________________
Pet's Name:_______________________________Description:__________________________________
I WOULD LIKE TO SPONSOR A KENNEL OR CAT SPACE (circle one). Family or Business name runs for 1 year.
$100 Name/Business to appear on plaque:_______________________________________________________
TOTAL ENCLOSED: $_____________