APPLICATION FOR MEMBERSHIP
CARROLL COUNTY ANIMAL PROTECTION LEAGUE
P.O. BOX 353
CARROLLTON, OHIO 44615-0353
contact information: carrollcountyapl@yahoo.com or
Our Public Relations contact is: Patti Willoughby - (cell) 330-205-9268
Please leave a message between 9 a.m. and 9 p.m. Patti will return your call ASAP - Thank you.
INDIVIDUAL ADULT MEMBERSHIP (18 years and older) $15.00 a year (Jan. 1st, to Dec. 31st.)
Name: __________________________________________Address:_____________________________________________________
City:__________________________________State________________________Zip Code_____________
Email:_________________________________________
Home phone with area code: (optional)________________________________________
INDIVIDUAL JUNIOR MEMBERSHIP (17 years and under) $5.00 a year. (Jan. 1st. to Dec. 31st.)
Name:_________________________________Age:______________
Address if different from above:_______________________________________________________
Extra donation of $__________________included in this membership application. (Thank you!)
Total amount remitted: $____________________. Check number: ______________Date: _____________________
Please tell others so they can know about us and our website: http://www.ccapl.webs.com Thank you!
Print out and send in to our address above. Make check or money order out to: CCAPL (Thank you!)
Note: Once you join us, we send a monthly newsletter to keep you updated on our progress and finances to date
via email or regular mail if you do not have email. (Paid membership is from January 1st to December 31st.)