Membership Application

Humane Society of Park County

 Membership Eligibility:
Any person, over 18, interested in the purpose for which this organization has been incorporated and expressing the desire to support and further the organization’s program may become a member by paying his or her annual dues to the Treasurer of the Humane Society of Park County.

A note to existing members: You can use this form to make an additional contribution or renew your membership. Every contribution, small and large, helps us take care of the animals in our area. Please help!

Please use this on-line form. When completed, please print your application and mail it to the Humane Society.

Name:
Address:
City: State: Zip:
My Donation: $

Annual Membership Dues

Voting/NonVoting:          No. of Votes:      Dues per Year:

 Individual
 Family
 Senior(60+)
 Student(19+)
 Founding Member
 Lifetime Member
 Honorary (non-voting)

1
2
1
1
2
1
0

$25.00
$50.00
$15.00
$15.00
Board Approval
Board Approval
Board Approval

Business Membership:

 “Puppies & Kittens”
 “Paws”
 “Strips”
 “Memorial & Bequests”

2
2
2
2

$100.00
$200.00
$300.00
$500.00

Please select your membership level and include a check with this form mailed to:
Humane Society of Park County,
P.O. Box 203, Cody, WY 82414-0203.
Your membership OR donation is greatly appreciated! Thank you!