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PLEASE PRINT CLEARLY AND COMPLETE EACH …

Membership Renewal Form PERSONAL INFORMATION UPDATE PLEASE PRINT CLEARLY AND COMPLETE each SECTION Membership Number: _____ Date of Last Renewal: (dd/mm/yy):_____ First Name: _____ Last Name: _____ Middle Initial(s): _____ Address_____ City: _____ Province: _____ Postal Code: _____ Date of Birth dd:____ mm:____ yyyy:_____ Place of Birth: _____ Phone: _____ Work: _____ Mobile:_____ Fax: _____ Email Address: _____ Website: _____ TYPE OF MEMBERSHIP RENEWAL FULL - Any person of Aboriginal descent within the meaning of s35(2) of the Canada Act, 1982 but NOT a band member residing on a reservation. YOUTH - Same as FULL membership only applicant is under 18 years of age. ASSOCIATE - Non-Status Indians, Status Indians or Individuals with Band Memberships who live on a reservation. MEMBERSHIP FEES SELECT YOUR PAYMENT 1 yr Renewal: 2 yr Renewal: 3 yr Renewal: 4 yr Renewal: 5 yr Renewal: Full: $ Fee: $ Fee: $ Fee: $ Fee: $ Youth: $ Fee: $ Fee: $ Fee: $ Fee: $ Associate $ Fee: $ Fee: $ Fee: $ Fee: $ * PLEASE Note - Youth Membersh

OATH I hereby make application for membership with the Ontario Métis Aboriginal Association –The Woodland Métis Tribe and do swear that all of the information contained herein is true to the fullest extent of my knowledge.

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