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Last Modified
06/24/10

Membership

 

Name:

Membership $:

Address:

Donation $:

Total $:

City:

Prov:

Postal:

Phone: Cell # : eMail:

Membership - please check the length of membership you wish to purchase:
1 year - $10.00 2 year - $20.00 3 year - $30.00 5 year - $35.00

By attaching payment I certify that I meet these Conditions of Membership:
- I am a Canadian Citizen or a Permanent resident of Canada
- I actively support the founding principles of the CPC
- I am at least 14 years of age

Payment Method: Cheque Enclosed Credit Card

Credit Card Type:
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Name on Card:
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Expiry Date: