Please accept this membership donation to help the animals.

____ $20 Individual    ____ $30 Family    ____ $100 Lifetime  ____ $15 Senior Citizen

Name: _____________________________________________

Address: ___________________________________________

City/State/Zip: _______________________________________

Telephone (optional): __________________________________

email (optional): ______________________________________

I am already a Lifetime Member. Here's a special donation of $________.

Mail your donation to: RCHSC / 5302 Desiard Street / Monroe, LA 71203

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