Print this form, complete it, and send it in with your dues to become a member of the CSRA Humane Society, or simply click here to visit our secure online payment website.

Name:__________________________________________

Street Address:__________________________________

City, State Zip:____________________________

Select a membership category:

• Individual ($35):____________
  
• Family ($50):_______________
• Corporate ($100):_____________
• Window Sponsor ($500):_____________
• 500 Club ($500 and up):_____________

Enclosed is an additional contribution of $_________________

I am currently a member and am enclosing an additional contribution of $_____________

I want to make a contribution IN MEMORY OF______________
or a contribution IN HONOR OF __________________________

I want to sponsor a pet as a Foster Friend:
Dog ($75)_____ or Cat ($75) _____

Please mail the completed form along with your contribution to:

CSRA Humane Society, Inc. 
P. O. Box 14667  
Augusta, GA  30919-0667

OR Donate through PayPal:

Help support our "NO-KILL" shelter

Thank you for your help!