| Name: | |
| Address: | |
| City: | State: Zip: |
| E-Mail: | |
| Phone: | |
| Message: | |
| Type of Member: | Active-Handles animals (Must be 16 years or older) |
| Associate-Does not handle animals | Membership Level: | Individual/$15 |
| Family/$30 | |
| Patron/$50 | |
| Corporate Supporter/$100 | |
| Benefactor/$250 | |
| Individual Life Member/$500 | |
| Family Life Member/$1000 |
| Request Type: | |
| Please mail me a Wildlife Rescue Team Brochure | |
| I am only sending you a comment or message | |
| Sign me up. Please print this completed form and mail to: | Wildlife Rescue Team, Inc.
P.O. Box 80127 Lincoln, NE 68501. |
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