Rivers and Bluffs Animal Shelter Membership Form

Your membership will help to build an animal shelter for the Greater Prairie du Chien, Wi Area. Please complete the form below. After pressing the Submit button, you will, automatically, be directed to the payment options.
After pressing the SUBMIT button above, the information will go to a special storage place on the web. You should receive a confirmation message within 24 hours.
The next page will be payment options.
Image verification
Enter Security Code
The Security Code:
Membership*
New
Renewal
Choose type of membership:
Email*
Verify Email*
First Name*
Last Name*
Address*
City*
State
Zip Code
Phone Number*
Alternate Phone
Student - $5.00
Individual - $15.00
Family - $25.00
Sponsor - $50.00
Patron - $100.00
Benefactor - $500.00
I would like to make a pledge of:
per month for a total of
per year. (Next page will have a button for payment.)
Method of payment:
I will pay by check or cash. (After pressing the Submit button, you will be directed to the payment page.)
I will pay by PayPal. This method allows you to use a credit card. (After pressing the Submit button, you will be directed to the payment page.)
Comment(s) Question(s)
Update Monthly Pledge
Version 5.5
Original Created 2/28/2008
.org created 5/27/2008
About Rivers and Bluffs Animal Shelter
The dream of an animal shelter in southwest Wisconsin is becoming reality. Rivers and Bluffs Animal Shelter will serve the counties of Grant, Crawford, and Clayton counties.

We realize that it may be years before we reach our goals. Our first goal is to raise money for land. Once we can purchase land, then we will start to fund raise for the actual building. We would hope to have enough money to run the shelter for a year before we actually take in animals.
Beer/wine tasting and Silent Auction Sponsored by Family Dog Center (Link)
Visit Our Friends Family Dog Center
Membership/Renewal Form
Riversandbluffsanimalshelter.org
Rivers & Bluffs Animal Shelter
PO Box 421
Prairie du Chien, WI 53821
Actively raising funds for an animal shelter serving Grant, Crawford, and Clayton counties.