Canadian Women’s Club of Atlanta

Membership Form – 2008/2009

(New members, please complete all sections.  Returning members, please write your name and changes, if any.)

 Name_____________________________________________________

Mailing Address ____________________________________________

City__________________________State________Zip Code_________

Phone______________________Cell____________________________

E-mail address______________________________________________

(If e-mail address is entered, notification of meetings, newsletters and other information will be sent to this address rather than by telephone or US mail)

 

Name of Spouse___________________

Where in Canada have you lived (start with last place)?  _______________________

Year you came to US _­­­_______

Year you joined the Canadian Women’s Club _____________

Languages spoken: English _____ French _____ Other _______________________

 

I will accept business solicitation from other Club members:   YES __ NO__

 

Birthday:  Month/Day ___/___   Wedding Anniversary:  Month/Day ___/___

 

New Members – How did you hear about the Club?

 

Membership dues:  (Must be returned by September 17 to be included in the printed membership list).  Please note that the Web password will be changed after September 17, and the new password will be given out on receipt of dues.

 

Regular Member (in the greater Atlanta area, including suburban counties)   $20

Member at Large (outside greater Atlanta area)                                          $10    

 

Please return with cheque payable to:

Canadian Women’s Club of Atlanta

c/o Membership Chairperson

425 Guildhall Grove

Alpharetta, GA  30022

Note:  This information will not be shared with anyone outside the Canadian Women’s Club