Shepherd Center Auxiliary Membership/Renewal

Personal Information

Address

Contact Information

Membership Category

Please indicate your category of membership:

  • Active ($30/year): I will actively participate in one or more Auxiliary activities.
  • Associate ($50/year): I cannot be active at this time, but want to support the Auxiliary.
  • Family ($50/year): This includes membership on the Peach Corps committee (see section below).
  • Life Circle ($300/one-time payment): I will actively participate in one or more Auxiliary activities.
  • You can also use this form to make a donation in the amount of your choosing.
$

Peach Corps

Peach Corps members and their children host two cookouts a year at Shepherd Center for patients and their families. There are no additional dues required.

Child #1
Child #2
Child #3
Child #4

Payment

Payment Details