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Our Logo Animals In Distress-Montreal

Membership Application

Fill in this form and mail it to the address listed below.

Name:

Address:

Telephone:

(Home)

(Work)

I wish to volunteer in the following area:

Dues: $20.00 - Member $15.00 - Seniors & Students.

Please make cheques payable to: Animals in Distress. Tax receipts will be provided.

Registration No#: BN 89155 8249 RR0001

Applications can be mailed to:

Animals in Distress

P.O. Box 174

Cote St. Luc, Quebec H4V 2Y3