2009 MEMBERSHIP FORM

Waikato Branch of The Royal New Zealand Society for the Prevention of Cruelty to animals Incorporated.

Name:

Address:

Email address:                                                          

Phone numbers  Hm:                                       Mobile:

Signature:                                                         Date:

SUBSCRIPTION RATES (Please tick)

Junior Membership     $5.00            Annual Membership     $15.00      

Family Membership     $25.00          Life Membership    $150.00            

Perpetual Membership    $5000.00 

NB: If you wish to make a donation, please add it to our subscription fee, thank you.

All rates are GST inclusive. Please tick the box if a receipt is required   

Receipt Number:                                                    Date issued:

SPCA Staff Member to sign:

Please tick the box if you are a new member   

Please tick the box if you are renewing your membership   

Waikato Branch of the SPCA                       Phone: 07-8474868

PO Box 15085, Dinsdale, Hamilton.             Fax: 07-8469221

219 Ellis Street, Frankton, Hamilton              Website: www.waikato.spca.net.nz

Subscription Period runs January 1st to December 30th following year

Please print and post or email to manager.spca@xtra.co.nz

Hardcopy is available in our office.