Heartland Humane Society

Membership Application

Please help us fulfill our important mission by becoming a member today.

Memberships run from May 1st of the current year to April 30th of the following year.

Individual...............$10.00
Family...................$25.00
Supporting...............$50.00
Patron..................$100.00
Lifetime(individual)....$500.00
Corporate..............$1000.00
Student(under 18).........$5.00
Senior Citizens(over 60)..$5.00
I (we) support Heartland Humane Society and enclose membership dues 
in the category __________________ with dues of $__________
 
Name________________________________________
Address_____________________________________
City___________________State_____ZIP________
 
Date_______________
Please mail this page to:
Heartland Humane Society
PO Box 1149
Ottumwa, IA 52501