Annual Dues & Donation Form

___ $15.00 Regular member

___ $5.00 Junior member age 14 and under.

___ $5.00 Senior member, age 65 and over

___ $5.00 Student member

___ $100.00 Life member, for self and spouse.

$_____ Sponsor/Donor who wants to support NHARL without being a member

$_____ Additional Donation

I have checked the appropriate boxes and have enclosed the total amount due:

Total Enclosed: $ ____________

Make checks payable to the NH Animal Rights League and mail to

PO Box 4211

Concord, NH 03302-4211 

Print Name:__________________________________

Print Mailing Address: ________________________

____________________________________________

City, State, Zip: ______________________________

___________________________________________

Telephone: ________________________

E-Mail: ___________________________