CASIS Membership Application

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__________________________________


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.


Address: (Please indicate whether home or business):     





Phone: (Home)______________________ (Business)________________________



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:__________________________________