CFUW / SARNIA LAMBTON

 

ANNUAL MEMBERSHIP APPLICATION FORM

2017-2018

 

If you are a returning member with no changes, please fill in your name only.

If you have any changes, please fill in the following.

 

NAME: __________________________________________________________________

ADDRESS: _______________________________________________________________

_________________________________________________________________________

PHONE: Residence:___________________ Business: _______________________

Email: ____________________________________________________________________

DEGREES: ________________________________________________________________

UNIVERSITY (UNIVERSITIES): ______________________________________________

_________________________________________________________________________

MEMBERSHIP FEE: $100.00 (All members)       Date sent: ______________

 

A $25.00/ $30.00 donation to the Bursary Fund is suggested in lieu of an annual fundraising event.

An official receipt will be issued.

 

 

 

 

 

Please make cheques payable to CFUW / Sarnia Lambton

And mail to the Club's Treasurer:

Heather Ashe

W51 - 1500 Venetian Blvd.

Point Edward

Ontario, N7T 7W4