Membership application and Annual Fees

To register, please submit the online membership form below, and pay online by e-transfer (treasurer@cfuwpq.ca)

If you prefer a paper form, please contact the membership coordinator and ask for a membership form to be sent to you (membership@cfuwpq.ca). Then you can either pay online by e-transfer (treasurer@cfuwpq.ca), or send your cheque (payable to CFUW PQ) back (to Box 113, Qualicum Beach, BC, V9K 1S7) with your completed membership form.

Registration

Fees to be be paid by September 01 for returning members

We accept new members all year

Membership Registration

Name *

First

Last Name *

Last

Are you a returning member?

Please select from the dropdown menu.

If you wish to share the way(s) you can help the club or reason for joining, please do so here:

Email Address *

Enter Email

Address

City

State/Province

Zip/Postal

preferred phone number

please enter your preferred contact number

alternate phone number

only provide this if cell is not an option for you

Please Select Membership Type:

Full - $120.00

Dual - $60.00

Student - $35.00

PERSONAL PRIVACY INFORMATION PROTECTION: To comply with the Personal Privacy Information Protection Act, we need permission to include your pictures on the CFUW PQ website, in our CFUW PQ newsletter, and/or in our club photo albums. If you agree, please select YES. If you DO NOT wish to have your photograph taken, please select NO

To comply with the Personal Privacy Information Protection Act, we need permission to include your pictures on the CFUW PQ website, in our CFUW PQ newsletter, and/or in our club photo albums. If you agree, please select YES. If you DO NOT wish to have your photograph taken, please select NO

GENERAL DISCLAIMER

please read

CONSENT to the General Disclaimer

I have read and give my consent to the General Disclaimer above

Date

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Membership Fees

Annual Membership Fees

Full:$120.00

Dual:$60/00

Student: $35.00

Membership Type

Full

anyone who identifies as a woman, and who supports the purposes of CFUW
Dual

a member of another CFUW club to which they are paying full dues
Student

anyone currently enrolled in High School, Trade School, University, or College