Membership Registration Form
(please print out)

Name:                           __________________________________

Address:                       __________________________________

City:                               _____________

Postal Code:                  ___________

Province:                       ___________

Telephone #:                 ___________

FAX #::                          ___________

E- Mail::                         ___________

Interest In volunteer opportunities:       Yes___       No___

Type of Membership:       New ____       Renewal____

Family ............................................... $45/ year........................ $ _______

Adult ................................................ $25/ year........................ $ _______

Senior (65 and over) ..........................$20/ year....................... $ _______

Student ..............................................$20/ year........................ $ _______

Basic Corporate ............................... $250/ year..................... $ _______

Non Profit Organization .................... $25/ year....................... $ _______

Individual Life .................................... $200.............................. $ _______

Senior Couple Life ............................ $250.............................. $ _______

Donation .................................................................................. $ _______

                                                        Total: .............................. $ _______


Please make cheque or money order payable to "Friends of the Farm".
A receipt for income tax purposes will be issued for all donations of $10 or more.

Print out this form and mail it with your payment to:

FRIENDS OF THE CENTRAL EXPERIMENTAL FARM
Building 72, Central Experimental Farm
Ottawa, ON K1A 0C6
Telephone: (613) 230-3276
Fax: (613) 230-1238
E-mail: info@friendsofthefarm.ca
Website: www.friendsofthefarm.ca

You can also visit us at Building 72 in the Arboretum.