Help the Wildlife Rescue League help our native wildlife through your membership.
	Please print this form and mail it to:
		Wildlife Rescue League PO Box 704 Falls Church, VA 22040
	Name: _________________________________________________
	Address: _______________________________________________
	City: _______________________________________________
	State & Zip Code: ______________________________________
	Phone number (day) : __________________ (optional)
	Phone number (evening) : __________________ (optional)
	Email : _________________________ (optional)
	Please indicate type of membership:
		___ Individual (1-yr) $25
		___ Individual (2-yrs) $40
		___ Rehabilitator $0 * With proof of current permit
		___ Family (1-yr) $35
		___ Family (2-yrs) $60
		___ Organization (1-yr) $35
		___ Organization (2-yrs) $60
		___ Donor (1-yr) $100
		___ Additional donation to help wildlife
	Total amount enclosed: _______________. Thank you!!
	A copy of the current financial statement for the Wildlife Rescue League is available by request from the Virginia Division of Consumer Affairs Office in Richmond, Virginia. The Wildlife Rescue League is an IRS 501(c)(3) organization. Donations to the Wildlife Rescue League are tax deductible as allowed by law.