Membership Form

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Members
Membership Form

Fees will be required before March 11th meeting. Only those who paid their fees will be allowed to vote during the meeting.

 

Membership Form

Mount Benson Preservation Society

Signature: ____________________________________________________________

Name: __________________________________________________________________

Organization: ____________________________________________________________

Position: ____________________________________________________________

Address: ____________________________________________________________
____________________________________________________________

City/Town: ______________________________________________________

Province: ____________________________________________________________

Postal Code: ____________________________________________________________

Telephone: ____________________________________________________________

E-mail: ______________________________________________________

My Areas of Interest/Research Include:_______________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

Student/Unwaged $30
Small NGOs*/Low-waged $30 - $60 **
Faculty/Professional $60
Institutional $80
Corporate $300

* Non-government organizations
** please pay what you can afford

Send this form directly to the office for the Society:

Secretariat
Mount Benson Preservation Society
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Copyright 2002 Mount Benson Preservation Society