2010 Membership Renewal Form:
FIRST NAME: ___________________________________________________________________________
LAST NAME: ___________________________________________________________________________
SPOUSE NAME : ________________________________________________________________________
COTTAGE ADDRESS: __________________________________________________________________
COTTAGE PHONE: ( ) _____________________ CELL PHONE: ( )__________________
CITY ADDRESS: ________________________________________________________________________
POSTAL CODE: -___________________________________ CITY: _____________________________
LAST NAME: ___________________________________________________________________________
SPOUSE NAME : ________________________________________________________________________
COTTAGE ADDRESS: __________________________________________________________________
COTTAGE PHONE: ( ) _____________________ CELL PHONE: ( )__________________
CITY ADDRESS: ________________________________________________________________________
POSTAL CODE: -___________________________________ CITY: _____________________________
I am a: Primary Member
______________________________________________
please print email address
- Option A Renewal : $50.00
Full Membership with Hard Copy Newsletter
Option B Renewal : $40.00
Full Membership with email version of Newsletter
sent to:
______________________________________________
please print email address
I am an: Associate Member*
______________________________________________
please print email address
* Cottage address must have Primary member registered
for an Associate member to join.
- Option C Renewal : $20.00
Full Membership with Hard Copy Newsletter
Option D Renewal : $15.00
Full Membership with email version of Newsletter
sent to:
______________________________________________
please print email address
* Cottage address must have Primary member registered
for an Associate member to join.
Donation $_________
| TOTAL $_________ |
| Please make cheques payable to : Gull Lake Cottagers Association and return to: GLCA c/o Marlene Robinson 2111 Lake Shore Blvd. W., Ste 121 Etobicoke. ON M8V 4B2 |