Membership Application

APPLICATION TO BECOME A MEMBER OF CLAN GREGOR SOCIETY SCIO

I hereby apply to become a member of Clan Gregor Society SCIO (“the SCIO”).

I give consent for my personal data to be used by the SCIO to contact me by mail, email or SMS in order to give me information about the SCIO’s activities or to obtain my opinion on any matter connected with the SCIO.

First Name(*)

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Middle Name(s)

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Last Name(*)

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Email(*)

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City(*)

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Postal Code(*)

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State/Province/County(*)

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Country(*)

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Phone(*)

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Occupation or qualifications

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Membership Option(*)

Individual 1 Year Membership - $45 CAD

Individual 5 Year Membership - $180 CAD

Family 1 Year Membership - $60 CAD

Family 5 Year Membership - $240 CAD

Please select and option

Payment may be made by Interac E-transfers to: treasurer@mapleleafmacgregor.ca No question or password is required.

Or

Postal address for correspondence and payments by cheque/money order:

Clan Gregor Society Canada Chapter,
Attention Wayne M Parker
PO Box 232,
Dorset, ON
P0A 1E0
Canada

The Maple Leaf MacGregor

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