Simcoe and District Humane Society

Simcoe and District Humane Society Receives no government or other agency funding. Moreover, relies solely on donations, fundraising events, membership dues from the community. Please Donate Now and Help us Continue to Help Those who Cannot Help Themselves!

Is this membership New Request or Renewal

New
Renewal

First Name:

Last Name

Birthdate m/dy/year

Street Address:

City:

Province

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Newsletters and Membership Information may be sent out by Regular Mail or Email (SMS text may be subscribed to)

Email Address:

Home Phone:

Cell Phone:

Please Check Type of Membership and Fee Enclosed: Membership for those over 18 includes Newsletters and Membership information and the right to vote at any Membership Meeting. Those under 18 may only hold a vote at Junior Membership Meetings.

I am a Life Member

Yes
No

Please Check Membership Type

Adult Membership @ $30.00
Other Adult Membership in Household @ $20.00
Senior Membership (55 years+) @ $15.00
 Student Membership (16 years+ with Student Identification) @ $15.00
 Youth Membership (12-16 with no adult membership) @ $10.00
 Associate Membership (Youth under 16 with adult membership) No Charge. All Memberships for those under 18 must have parental consent.

Your Consent is needed to add your information to WhenToHelp Schedule Program which helps us let you know how you can help and when meetings are. This DOES Help Us and you can set up notifications!

Your Consent to Contact you Via Cell Phone, Home Phone, Email, and add your information to our WhenToHelp Database.

Consent to contact you on Cell Phone
Consent to contact you on Home Phone
Consent to contact you on by email
Consent to contact you on Regular Mail
Consent to add your information to our WhenToHelp database.

• Your Support Helps! Are you adding a donation above your Membership Fee?

$10
$20
$50
$100
Other amount (Please let us know how much below)
Not at this time

Amount of Donation above membership

You will pay for your membership and donation if added to Membership by:

Visa, MasterCard, DebitVisa in person at the shelter 24 Grigg Drive, Simcoe, ON
PayPal from website
e-transfer finance@s-dhs.ca Please Quote "Membership Dues" in Message Box
Staff may call me to apply my visa, mastercard over phone

Volunteerism is important to the Society. Would you like to Volunteer?

Fundraising and events
Interested in Driving Animals to/from Spay/Neuter Clinic (2-3 times per month London, Kitchener, Dunnville
Fostering is an integral part of the animal care in the Society. Would you like to Foster?
We need people to boost our Social Media Post - must be able to work around our programs and share animals and events
Coordinate, prepare adoption packages, look after PetSmart Adoption Program

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User Agreement

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Your submission of this form will be equivalent to your signature.