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        Animal Compassion Network Membership Application
              "Joining Paws Across The Mountains"

                          Mail to: 
   Animal Compassion Network, PO Box 1704, Skyland, NC 28776

Name ___________________________________ E-Mail _________________

Home Phone (with area code) _______________ Other # _____________

Fax# _________________________ Best time to call: _____________

Mailing address ___________________________________________

City _______________________ State ______ zip code ____________ 

Method of payment	__ Money order	__ Check	__ PayPal

__Please save postage and send me future newsletters via email
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              TYPE OF MEMBERSHIP (Check one or more)
If gift membership, please also fill out section at bottom of form

__ Basic                                                   $25.00
__ Friend                                                  $50.00
__ Contributor                                            $100.00
__ Benefactor                                             $250.00
__ Patron                                               $1,000.00
__ Founder                                              $2,500.00
__ Additional Donation                                  $________
                                         ========================
(Make check or money order to "ACN".)    TOTAL ENCLOSED: ________

ACN is designated as a 501(c) 3 non-profit.
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                     Volunteer Opportunities
              (check all that you are interested in)

__ Foster Care			 __ Adoption Events
__ Cat Care at PetsMart          __ Marketing/Advertising
__ Fundraising                   __ Clerical/Office Work
__ Public Education              __ Outreach
__ Phone Team                    __ Other: _______________

Upon receipt of your application, an ACN representative will
contact you to discuss volunteer opportunities you checked in
detail. 

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__Please acknowledge my Gift Membership to:

Name ___________________ Address _______________________________

City ________________ State __________ Zip _____________

Phone __________________Email ________________________

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           Thank you in advance for your contribution.