Membership Form

Indiana Horse Rescue Central West

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Membership Form

Animal Protection Coalition is always happy to accept new members.
If you are joining us through our website, you can complete the following and use PayPal to pay your membership
or print out this form and mail it, along with your membership fee to:

Animal Protection Coalition
Membership - IHR Central West
10254 W 800 S
Owensville, IN 47665
(812) 729-7697

Please Do Not send cash, make checks or money orders payable to
Animal Protection Coalition.

Membership fees are considered donations and are nonrefundable.
Your membership fees go directly to care for the animals we rescue.
All memberships last for one year after they are issued.

Name

Business Name

Address

City

State, Zip Code

Daytime Phone

Evening Phone

E-Mail

Do you Own a Horse?

Do you own a Dog?

Cat?

Other Pets?

Membership Types:

Student	$10.00	Yearly
General	$25.00	Yearly
Organization	$75.00	Yearly
Sponsoring	$150.00	Yearly
Lifetime	$1500.00	Yearly

Contact Name

If this is to be a gift, please complete the information below
Name

Address

City

State, Zip Code

Daytime Phone

Personal Note

Please make check payable to Animal Protection Coalition
or click below to use Pay Pal.

Event Sponsor

Lifetime Member $1500.00

Your membership packet will include a membership card and certificate, your "IHR dog tags" and information on how to get involved in the programs of Animal Protection Coalition, such as Volunteering, Sponsoring, Adoption, and all other aspects of working within the organization. All our members work on a volunteer basis. Animal Protection Coalition is a 501(c)3 Non-Profit Organization.

With Your Help...We Will Make a Difference
Please call us if you have any questions: (765) 532-7440

Indiana Horse Rescue Central West
West Lafayette, IN 47906
(765) 532-7440
Fax (206) 338-5604

E-mail