Membership Form

Canada Japan Society of Ottawa

 

Name: __________________________________________________

 

Address:   ( same as now listed or use address below):

________________________________________________________

 

________________________________________________________

 

E-mail address:  __________________________________________

 

Telephone: (same as now listed or use numbers below):

Home Phone:   __________________________

 

Office Phone:  ____________________________

 

Please check type of membership desired:  New_____ or Renewal  _____

            _____ Individual ($15.00)

            _____ Individual senior    ($ 5.00)  

            _____ Family   ($25.00)

            _____ Student Visa/ Work Holiday Visa (no charge). Visa expiry month _________

 

If family membership, please list all family members and indicate ages of children under 16:

 

__________________________________________________________

 

___________________________________________________________

 

___________________________________________________________

 

Our newsletters are available by e-mail!   Please check if you would like to receive the e-mail versions instead of paper copies   _________ 

(Photos of digital version are in colour)

 

Reminder and confirmation of attendance at monthly dinners (please check only one):

            Contact me by e-mail: _____

            Contact me by phone: _____

            Do not contact me; I will contact CJSO when I wish to attend: ______

 

Please do not send cash by mail. Make your cheque or money order payable to: Canada Japan Society of Ottawa

and mail it to:

CJSO Membership
P.O. Box 8260, Station T
Ottawa, ON K1G 3H7

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