Twin County Humane Society Membership Form

TCHS 2024 MEMBERSHIP FORM

P.O. Box 125, Hillsville, VA, 24343 | Helpline: (276)779-9418, tchshelpline@gmail.com twincountyhumanesociety.org | Facebook.com/twincountyhumanesociety
Be a part of the lifesaving work that TCHS provides to animals in the Twin Counties.

Join today!
What type of membership are you interested in?

Personal membershipLocal business sponsorshipBoth
Personal Membership (you may choose more than one):

Individual - $25Family - $50Student/Senior - $15Patron* - $100Gift** - $25
Members may receive a TCHS sticker if they would like (check below).

*Personal membership donations of $100 or more are eligible to receive a gift of a TCHS hat or T-shirt!

**Gift membership recipients will receive a card with a brochure and sticker, and the name of the giver.
Please check below if you would like to receive a TCHS T-shirt or hat.

T-shirt please!Hat please!
What size T-shirt would you like?

SmallMediumLargeX-LargeXX-Large
For gift membership, please provide name and mailing address of recipient below. Specify if you wish your gift to remain anonymous.
Local Business Sponsorship (please choose one):

Beagle - $100Border Collie - $250Golden Retriever - $500Great Pyrenees - $1,000
All business sponsors are eligible to be named on our website for the calendar year.
Please check below if you would like your business to be named on our website.

Yes, please include my name as a sponsor on the TCHS website.
Please check below if you would like to receive a TCHS sticker.

Yes please!
Would you like to add an additional donation amount to your membership?

Yes I would!Not at this time, thanks.
How much extra would you like to donate?
Check if you would like to receive information about fostering animals or volunteering with TCHS. Or go to www.twincountyhumanesociety.org/get-involved for more information or to sign up.

Yes please!Not right now, thanks.
Name

First NameLast Name
Business Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Phone Number

Area CodePhone Number
Call us at (276)779-9418 or email us at tchshelpline@gmail.com if you have any questions.

All memberships are valid for the calendar year 2024.

TCHS is an all-volunteer 501(c)(3) organization. All membership fees are tax deductible.
Your total is:
Total Payment is:

prevnext( X )
USDDescription

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

TCHS 2024 MEMBERSHIP FORM