Membership form

Welcome! Simply print and bring this form and your dues to the next monthly meeting and give them to one of the executive members. If you cannot print the form, not to worry — we will have copies for you at the general meeting.

☐ New member or ☐ Renewal

Name (print clearly):
Email address:
Street address:
City, province, postal code:
Home phone:
Business phone:

Dues enclosed ($25/year): $

I agree to uphold the constitution of the London Writers Society and comply with its bylaws. I give the society my consent to hold and process the information on this form for the purposes of establishing my membership, notifying me of meetings and events, and for archives, statistics, and other membership activities.

Signature:


Date:

The London Writers Society will not share your individual personal information on this form, unless ordered to do so by a court of law. The society may use this information to contact you, based on your membership in the society. Cheques returned for insufficient funds will be charged a $25 handling fee.

For office use only
Method of payment:
Beginning date:
Expiry date: