Membership Application - Paperless / Credit Card If you have never used PayPal before, no problem!  Just follow the steps below and we will walk you through the entire process. Paying the Membership fee using PayPal is fast, free and secure!  (PayPal accepts Master Card, Visa, and others.) If you would prefer not to use PayPal, please call our office at (309)451-1000 and pay with your credit card over the phone.

1.	Select the Membership link for the level you would like to donate. The PayPal window will display after you select a link. (If you receive a Security Alert message, select the OK button to proceed.)

$1,000 Patron $500 Sponsor $250 Friend

$100 Benefactor $75 Supporting $50 Buddy

$35 Family $20 Individual $10 Junior

$        Special

2.	If you selected the Special membership, you will need to enter the amount in the Amount box.

3.	If you are not a registered PayPal user, select the "If you do not currently have a PayPal Account Click here" link, complete the "Sign up for a PayPal account today!" section, and select the Continue button,
	- OR -
	If you are a registered PayPal user, enter your Email Address and PayPal Password in the appropriate boxes and select the Continue button.

4.	Review the Payment Details to make sure they are correct.

5.	Verify the Shipping Information to make sure the Ship to address is the place you receive your credit card bills.

6.	Select the Pay button to process payment and wait until the "You Made a Payment" window displays.

7.	Select the Return To Merchant button to return to this webpage and complete the remaining steps. (If you receive a Security Alert message, select the Yes button to proceed.)

8.	Enter the following information. (Please fill in all fields that apply. * = Required )

New Member	- or -   Renewal   *            Date:
Name:	*
Street:	*
City:	*
State:	Illinois Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *           Zip Code:  *
Home Phone:	Work Phone:
Email:	*
Employed By:
Spouse's Name:
Spouse's Employer:
Children Living   At Home:   (Names & Ages)
Please list any pets:

9.	Confirm the Membership amount: $ *

10.	What method of payment is being used?   PayPal    Through our Pet Adoption Center

11.	Select the Submit Membership Form button, and that's it!

Contributions made to the Humane Society of Central Illinois are tax deductible to the full extent allowed by law. Thank you for joining the Humane Society of Central Illinois. We look forward to your participation.

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