Donation Form - Please print page, fill out and send to:
The Milford Humane Society, P.O. Box 171
Medway, MA 02053, (508) 473-7008

Name:_____________________________________

Address:___________________________________

__________________________________________

__________________________________________

Phone:_____________________________________

Yes! I would like to join the Milford Humane Society. Enclosed is my tax deductible membership contribution in the amount of:

$_______ $5.00 Junior/Senior/Student
$_______ $15.00 Individual
$_______ $25.00 Family
$_______ $50.00 Sponsor

$_______ Adopt-A-Cage - $10.00 per month

$_______ C.A.R.E. Fund

Building Fund:
$_______ Reception Area - $10,000.00
$_______ Cat Rooms - $10,000.00 each
$_______ Infirmary - $ 5,000.00
$_______ Special Needs - $ 5,000.00
$_______ Kitten Room - $ 5,000.00
$_______ Admissions - $ 5,000.00

$_______ Protectors - $ 2,500.00 - up
$_______ Benefactors - $ 2,499.00 - $2,000.00
$_______ Best Friends - $ 1,999.00 - $1,500.00
$_______ Supporters - $ 1,499.00 - $1,000.00
$_______ Companions - $ 999.00 - $ 500.00
$_______ Cat Lovers - $ 499.00 - $ 100.00

$_______ Buy a Brick Donation Program - $25 each

Who do you want to dedicate donation to:_______________________________________

______________________________________________________________________

______________________________________________________________________

$__________ TOTAL ENCLOSED

Please make check payable to Milford Humane Society.

Thank You For Your Generosity!

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