HUMANE SOCIETY OF JEFFERSON COUNTY
MEMBERSHIP APPLICATION
Send to: P O Box 653 - Jefferson City, TN 37760
Name ______________________________________________ ____
Address ______________________________________________________
City State Zip Code
Home Phone No. (optional)
E-Mail Address (optional) ____________________________________
I wish my contribution/membership to remain anonymous.
(We occasionally acknowledge/thank people publicly for their support)
I agree with the Mission of the Humane Society of Jefferson County. (Must be
checked) Our MISSION is to promote and foster humane treatment and respect for
all animals; to advocate for their welfare and adoption, when possible; to free them
from abuse, neglect and suffering; to reduce the overpopulation of animals through
spay/neuter programs and to encourage effective pet identification.
I would be willing to volunteer in the following areas:
check those in which you are interested and would welcome a phone call:
Building/Grounds Maintenance
Computer Skill
Animal Socialization
Special Events
Emergency Foster Care
Membership categories:
Individual Member $10
Junior Member
Life Member $500
Other
Total enclosed _________
Date approved _________________