Get Involved – Become a Member

Enrolling on-line is as simple as filling out this form.

What will happen – After you complete this form we will process your application then let you know when when your membership has been approved.

If you would prefer to enroll by mail, please download our application form.

* Required Fields

Personal Information

*First Name:

*Last Name:

*Email:	*Phone:
*I prefer to be contacted by: Email   |   Phone

*Address:

*Is this your credit card billing address: Yes   |   No

*You can contact me to help with the animals at the Shelter.  Yes   |   No

*You can call me for assistance with the SPCA's activities.  Yes   |   No

Type of Membership

*Type of Membership:	Please SelectLife $1,000 Protector $500 Benefactor $250 Advocate $100 Family $75 Adult $50 Junior/Senior $20
Membership Level:
Yearly Dues:	$
Additional Donation (optional):	$
Total to be charged:	$

Payment Details

Important! We do not use on-line payment processing at the moment. Instead, we process your credit card at our offices. If you are uncomfortable supplying the following information online, just leave it blank and we will call you for your credit card details.

Billing Address (if different to above):
Card Type:
Name on Card:
Card Number:
Expires on:	Month: -- 01 02 03 04 05 06 07 08 09 10 11 12   Year: -- 07 08 09 10 11 12

*Spam security:

Type the characters you see in the picture below.