P.A.W.S. OF SOUTHWEST VIRGINIA, INC.
People for Animal Wellness & Safety
P.O. Box 576
Coeburn, VA  24230
(276) 523-6819


YEARLY MEMBERSHIP DUES ARE AS FOLLOWS:

ADULTS - $10.00
STUDENTS - $5.00
SENIOR CITIZENS - $5.00
* You may also contribute in the name of your pet for $5.00 annually.*

One-time donations of any amount are also greatly appreciated.
We cannot continue without your support.
All donations are tax deductible.

To become a member or make a one-time donation,
please complete this form.


NAME:        ____________________________________________

ADDRESS:   ____________________________________________

PHONE:       ____________________________________________

E-MAIL:      ____________________________________________

MEMBERSHIP ENCLOSED:   $___________    DATE: _________

ADDITIONAL OR ONE TIME DONATION:   $_______________

Would you like information on ways you can volunteer with PAWS?  Yes___  No___       
Would you like to be notified of upcoming events sponsored by PAWS, i.e. adoptions,        fundraisers, etc.?   Yes____   No____                                                                         

Please make all checks payable to P.A.W.S. of Southwest Virginia, Inc.
Mail completed form and donation/dues to above address.

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