• Facebook Social Icon
  • Twitter Social Icon
  • Google+ Social Icon

Membership application

 

Name : .....................................................................

Date of Birth : .....................................................................

Physical Address : ..........................................................................................................................................

Postal Address : ..........................................................................................................................................

Phone Number Home : ....................................................................    Cell : .....................................................................

Email : .....................................................................

Have you got animals ? :        Dog : ........ ; Cat : ....... ; Others : .......................

 

I hereby declare that I wish to become a member of the non profit making organization Bien Naitre Animal.

I understand the purpose of the organisation and I wish to become a member through contributing a membership fee for 1 year.

I wish to donate .................................... (minimum fee 36$AU, 27$US, 25€, 22GBP) by paypal or credit card.

Signature :                                                                          Place and Date  :                                        

 

Under the data protection act your details will not be shared with others.

Become a member and contribute to the sterilization and protection of animals

I invite you to download your membership application in .docx or .pdf, to fill it and to return it to us by email :
The dogs and cats of our beautiful New Caledonia love you and thank you for your help ! Woof, prrrr, prrr!

Non profit making organization helping with the sterilization, the protection and the development of wellbeing for dogs and cats in New Caledonia