Membership Application Form

MEMBERSHIP TYPE: NEW __ RENEWAL __

SURNAME _____________________ FIRST NAME _______________________

OTHER FAMILY MEMBERS YOU WISH TO LIST:

____________________________________________________________________

STREET _______________________________________________________

CITY ________________________________ PROV. ___________________

POSTAL CODE ________________________

HOME PHONE ____________________ BUSINESS ____________________________

E-MAIL _________________________

LIST NAME & ADDRESS IN NEWSLETTER? YES / NO (CIRCLE CHOICE)

LIST NAME ON WEBSITE? YES / NO (CIRCLE CHOICE)

With your membership you will receive:
the Windsox Newsletter 4 times per year,
and insurance coverage during club events.

PLEASE PRINT AND ENCLOSE $25 MEMBERSHIP FEE
MAIL MEMBERSHIP FORM AND FEE TO:
BCKA
Box 755
#101-1001 WEST BROADWAY
VANCOUVER, BC V6H 4E4

E-mail membership inquirees to membership '@' bcka.bc.ca