Phone #: ______________________________ [ ] Male [ ] Female
The annual membership fee is for the period January 1 to December 31.
Cheques payable to: Cambridge & District Humane Society
Please indicate the type of membership you are applying for:
[ ] Youth (to 17) CAD $15.00
[ ] Senior (65+) CAD $10.00
[ ] Adult (18+) CAD $25.00
[ ] *Family CAD $40.00
* Family Membership includes your spouse and children under 18 years of age.
Please list their names below if you selected the Family Membership.
Note: Only members who are 18 years of age are eligible to vote at the general
meeting of the society.
If accepted as a member of the Cambridge and District Humane Society I promise,
on behalf of myself and all members of my family listed above, that I/we will uphold
and abide by the By-laws of the Society.
To operate the animal shelter and to provide the animals in our care with love and
attention, the Society requires the help and assistance of many volunteers. If you
or any member of your family who is over 16 years of age would like to offer even a
small part of your time for this purpose, please ask for a volunteer application form.
For Office Use:
Date Paid: ________________________ Card Given: [ ] Initials: ____________
