|
 
Membership/Renewal Application
Name_________________________________________________________________
Street_______________________________________City_______________________
Prov./State_______________________Postal Code/Zip___________
Phone___________________________ E-mail_______________________________
Additional Members:____________________________________________________
|
1 Year |
Family |
_____ x [$20 Cdn] =
$________ |
|
Single |
_____ x [$15 Cdn] =
$________ |
|
Youth |
_____ x [$8 Cdn] =
$________ |
|
3 Year |
Family |
_____ x [$50 Cdn] = $________ |
|
Single |
_____ x [$40 Cdn] = $________ |
|
Youth |
_____ x [$20 Cdn] = $________ |
|
|
|
TOTAL
$_______
|
|
New Member ( ) Renewing Member ( ) |
Please indicate if you consent to have
your contact information name, mailing address, phone number and email
address) to be listed on the Can-Am, Fall Meeting and Membership Rosters.
Yes ____ No __
Make Cheque payable to the Ontario
Daylily Society
|