Membership Application

Membership Application

Please fill this form out, print it out and mail to Autumn Winds Animal Rescue with your payment.

Autumn Winds Animal Rescue
PO Box 1178
Dixon, MO 65459

Please be assured that your information will never be given to anyone else and only used to keep you informed of ongoing activities at Autumn Winds.

Membership Types:
Please only check one.

Individual ($15.00)

Family ($25.00)

Lifetime ($150.00)

Date:
MM/DD/YYYY

Name:

Address

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Phone:

Email

Please select if you are interested in helping
with any of the following:

Fundraising

Fostering

Volunteering

Events

Socializing the Animals

Additonal Information:

In the near future we will have a newsletter made available, we will provide this in electronic and paper formats.

We will use your email to let you know of upcoming events, fundraisers and adoption events.

PowEmail Forms

E-mail: crittercare@autumnwinds.org