Please return the form to :

 

Base Gagetown Community History Assoc., 
P O Box 20086,

 Saint John NB E2L 5B2

 Membership Application Form   

July 1, ______

             Year  

to

  July 1, ______

               Year  

                

NEW   ____     RENEWAL  ____

NAME ______________________________PHONE # _____________

ADDRESS__________________________________________________

Postal Code _____ ______ E-mail __________________________

Committee

Community Interest______________________Participation   Yes___ No ___

Family Interest___________________ Date _____________________

Type of membership, Individual-$10.___ Family-$20. ___ Life-$100. _____

Annual Corporate membership $500. _________

 

Membership renewal is due July 1st  of each year.