Canadian Women’s Club of Atlanta
Membership Form
(New members, please complete all sections. Returning members, please write enter only
your name and any changes).
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__
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 Cherokee, Clayton, Cobb, Coweta, DeKalb, Douglas,
Fayette, Forsyth, Fulton, Gwinnett, Henry, Paulding,
Rockdale 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
640 Parkside Village Way
Marietta, GA 30060
Note: This
information will not be shared with anyone outside the Canadian Women’s Club