(Please print this form and enclose in your envelope. Thank you.)



Membership Application Form

I wish to become a member of the NDG Food Depot.

Name
Address
Postal Code
Telephone
e-mail
Category:
  ♦ Regular Member @ $5/year (or 5 hours volunteer work/year)
  ♦ Supporting Member @ $25/year
  ♦ Benefactor @ $100/year (or more)
Date
Signature

Please make your cheque to NDG Food Depot and send to 2121 Oxford, Montreal QC, H4A 2X7.

Thank you.