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Membership Form AASK SERVICES c/o H. Hazen P.O. Box 180 - Milo, Ab. T0L1L0 Canada I want to become a member of Animals Alone Society of Kindness (A.A.S.K.) Services. I am interested in the primary objectives of this organization which are: - "to utilize the good in animals to benefit the good in people" I endorse the raising of funds to sustain a no-kill animal shelter; - Aid in the rescue and rehabilitation of abused and abandoned animals; - I endorse AASK Services Spay and Neuter programs that assist in education and information that hinder unwanted births. - Find foster and adoptive homes for homeless animals and for those that are not adopted, to implement them into animal assisted programs that help people! And most of all, allow animals to do what they do best, loving people! ************************************************************************************************ Name: ______________________________________ Date of Birth _______/ _______________/ _________                      date:       month       year Street Address: _________________________________________ City/Other: _________________ Prov:_______________ Postal Code:______________ Telephone Number________________________       E-Mail Address: _______________________________ (please check off option) -Receive Newsletter by? ____ Email or ____ Postal Mail Email Address: ________________________ pl note: postal delivery options are an additional $10 to Member Fees Applicable if living close to us in Southern Alberta, Canada. I would be interested in helping with chores and other: cleaning, feeding, laundry etc. _____________________________________________________________________ _____________________________________________________________________ If you have something specific that you'd like to do, please add it below: ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ **Please Sware in writing below, that at no time were you ever charged for a violent crime against people or animals. __________________________________________________________________________________________________________ Please (print and or) complete this form with the according funds. Please type or print legibly all information except your signature. Youth (under age 18)     $10.00 Adult (age 18-59)      $15.00 Each additional family member (same address - except for Seniors) $10 Senior Citizen (age 60 and older)      $5.00 Those seeking the Bi-Monthly Newsletter delivered by postal mail, add an additional $10. to the fees Dues will be billed on an annual basis covering January through December. Fees remain the same during each year, no matter when joining. Signature: __________________________________ . Date: _______________________________________. Amount enclosed: $_____________ Additional Family Members Names (if any) included in amount enclosed - for the additional membership cards: _________________________________________________________________________ _________________________________________________________________________ **************************************************************************************************************************************** ****************************************************************************************************************************************            Animals Alone Shelter Use ONLY Board Member Approval: _________________________________________ dated ____________ Comments on Member availability to assist with tasks or volunteering: ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ _________________________________________ dated ____________ _________________________________________ dated ____________ witnessed by: __________________________

Pay by Email Money Transfer c/o Karen Fike - Treasurer or Mail funds by certified check or money order - along with this application to: A.A.S.K. Services C/O Heather Hazen - P.O. Box 180 Milo, Alberta Canada T0L1L0 ©Animals-Alone