CASIS Membership Application
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Please print this form, then complete it and send along with a cheque or money order, payable to �CASIS�, to:
CASIS
Secretariat, PO Box 71007, RPO L'Esplanade, Ottawa, Ontario, K2P 2L9
I wish to join in the following category (all amounts
are in CDN$):
��� $35.00 -
Regular Member;
��� $25.00 - Students; Student Number__________________________________
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Educational Institution_____________________________________________
��� $25.00 - Seniors (65 and over), Retirees.
A tax deductible receipt will be issued to Canadians paying
their own fees.
I am renewing my membership. ��� I am a new member.
Name:________________________________________________________________
Address: (Please indicate whether home or
business):
�______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Phone: (Home)______________________ (Business)________________________
E-Mail:_______________________________________________________________
I consent to my contact information being
shared with other CASIS members.
����������������������� �YES������������������ NO
Contact information will not be shared
without the consent of the individual.
Date: ______________________Signature:__________________________________
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