Serving the Eastern Townships English-speaking Community since 1979.

Membership Form


 
Check One:  New Member  
 Renewal ID#


First Name: *
Last Name: *
First Name:
Last Name:
Address: *
City: *
Province: *
Postal Code: *
Telephone: *
E-Mail Address:


Information for our statistics - Thank You!

No. in family: 

Individual's / each family member's gender & year of birth:

Reside in Townships?  No   Yes    No. of years?


 


Membership Fee:

  1 Year 3 Years Lifetime
Individual $15 $35 $125
Family* $25 $65 $125
Seniors (65+) $10 $25 $100
Seniors (65+) Couple $15 $35 $100
Community Group $15 $35  
Business $25    
Donation*
*Family: Lifetime fee applies to couple only
*Donation: The Association is not able to issue receipts for tax deduction purposes.

Total

Please send cheque to Townshipper's Association:

100-257 Queen
Lennoxville Qc J1M 1K7
Tel.: (819) 566-5717
TollFree: 1-866-566-5717
Fax: (819) 566-0271 		203 Principal
Cowansville QC J2K 1J3
Tel.: (450) 263-4422
Tollfree: 1-866-263-4422
Fax: (450) 263-6317

Email:ta@townshippers.qc.ca / Website: www.townshippers.qc.ca