Membership Form

MEMBERSHIP APPLICATION

  Name ……………………………………………………………………………………………………………………
  Corporation ……………………………………………………………………………………..…….......…….……………….
  Address ……………………………………………………………………………………………………..….……………
  City Province/State Country
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  Home Phone ……………………………………… Business Phone ........................................................ ...
  E-mail Address ……………………………………………………………………………………………….................…………..

  Do you wish to volunteer on any of the Committees? ……........................................................................

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 …………………………………………………………………………………………........................................  Annual Dues

  Regular and Affiliate Membership ………………………………………………………$ .___________

  Corporate Membership……………………………………………………………….…...$ ___________
 
 

  Donation to Restoration Fund …………………………………………………………...$ ___________

  Signature ……………………………………………………………………………………………………………....………
  Donations are income tax deductible. Please ask for a receipt.

  Mailing address: West Vancouver Fire Service Museum & Archives Society
  604 East 21st Street, North Vancouver, B.C. V7L 4V8

    Phone: 604-986-1552 E-mail: howardmoody@shaw.ca

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