E-Mail:
Address:
City/Province:
PostalCode:
Phone/Fax:
ONE-YEARMEMBERSHIPFEES
$10individual
$25Family*
$5youth(15-29yrs)
$5senoir(65yrsplus)
Iwishtomakeadonationinadditiontomembership$
*Names&AgesforFamilyMembership(and/orcomments):
Chapter:
Montreal/Westmount
UpperLaurentians
LowerLaurentians
Laval/NorthShore
MontrealRegion
MontrealEastIsland
Saguenay/LacSt-Jean
ProvincialYouthCommission
St.Maurice
SouthShore
WestIsland
AbitibiEast
AbitibiWest
BaieComeauCommunityOrg.
CoteNordCommunityOrg
Idonotknow?
(orareaofQuebec)
Payment:Visa
Mastercard
Cardnumber
(Expirydate:)
Checkoffyourareasofinterest:
HealthandSocialServices
Business&Employment
NationalUnity
Membership&Fundraising
LegalIssues
YouthIssues
CommunityActivities
Education
CulturalCommunities
*
PSThejobpaysastipendof$25,000ayear.
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