Member Registration
| Name: | ||||||||||||||
| Address: | ||||||||||||||
| City: | State: | Zip: | ||||||||||||
| Email: | ||||||||||||||
| I would like to make a cash contribution $_______ | ||||||||||||||
I would like to be a member of HSIMC:
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All donations, including those for membership, are tax deductible. Please send your check along with the above form to:
Humane Society for Inland Mendocino County
9700 Uva Drive
Redwood Valley, CA 95470
Phone (707)485-0123
Fax (707)468-1197



