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 - Yo

Membership Renewal Form . PERSONAL INFORMATION UPDATE PLEASE PRINT CLEARLY AND COMPLETE EACH SECTION Membership Number: _____ Date of Last Renewal: (dd/mm/yy):_____

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