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Friends of Ecological Reserves

Friends of Ecological Reserves
Box 8477 Stn Central VictoriaBCV8W 3S1

Membership & Donations Form

1. print this form and complete it manually, OR
2. complete the form on-line, then print it AND
3. send with your cheque to the above address.


Name (Please Print)
Street Address
City
Province/State
Postal Code
Phone (optional)
eMail (optional)
        		                    
Send me The Log via email. Check this box if instead of receiving the LOG by post as a paper version, send me my copy of the LOG electronically in PDF format.
Membership Type New Member Renewal
Category Individual: $20.00 Student: $15.00
Senior: $15.00 Family $25.00
Institution: $25.00
Payment for Membership $
Donation (tax receipt BIN#118914597RR will be issued for any donation of $20.00 or more) $
Copies of Constitution @ $1.00 ea. $
Total Cheque/Money Order Enclosed $
Apply my donation to: I am interested in volunteering for:
Land Acquisition Assisting with Field Trips
Research Grants Assisting with The Log
Where Most Needed Assisting with Fund Raising
Assisting with telephone work
Other