Nan Pipestem Wildlife Rehabilitation Center Donation and Volunteer Form

P.O. Box 2244
Hollister, CA 95024
831-628-3400

PLEASE FILL OUT THIS FORM, PRINT IT AND MAIL IT ALONG WITH YOUR CONTRIBUTION TO THE ABOVE ADDRESS
YES! I want to support wildlife rehabilitation in San Benito County

NAME
ADDRESS
CITY, STATE ZIP
PHONE	FAX E-MAIL

I want to become a member!

Annual memberships:
$ 100 - $499 Business/Community
$ 40 - Family
$ 70 - Family 2 years (Save $10.)
$ 25 - Individual
$ 45 - Individual 2 years (Save $5.)
$ 10 - Senior / Junior / Student

Lifetime memberships:
$1000 or more Benefactor
$ 500 - $999 Sponsor

Cash Contribution (every little bit helps)

Yes, I would like a screen saver for my
Windows 95 or newer PC.

YES!! I want to contribute to the Endowment Fund

I would like to make a donation to increase the Endowment Fund.

Amount For the endowment fund, please make checks payable to: Community Foundation/ Wildlife Center.

YES!! I want to make a difference!!! - I want to volunteer
(please check all that apply)

to be a board member
to help with the newsletter
to work in the fireworks booth

to help organize the dinner/auction
to maintain & repair wildlife habitat
to care for & feed sick & injured animals

Nan Pipestem Wildlife Rehabilitation Center
is a non-profit (501(c)3) volunteer organization
- REHABILITATE - RELEASE - EDUCATE -