Own Membership
Application for 2008
□ New
□ Renewal
□ Requested:
$35.00 □ Low Income: $25.00 □ Organization: $60.00
□ Sustaining
Member (Pre-authorized Chequing) see below
Where I Can Help
□ OWN office □ Membership and social event
committees
□ Public
education forums □ International women’s issues
□ Web site and
communications □ Fund raising □ Telephone Caller
Name:
____________________________________________________
Address:
______________________________City _________________
Prov.: _________________ Postal Code: ________________________
Telephone: ____________________
E-mail: ______________________
I would like to become a sustaining member of OWN and give year-round,
making it cost effective and easier for OWN to make long term
plans.
I would like to give monthly □ $5.00 □ $10.00 □ $15.00 □$25.00 or □ $
______ . I
authorize OWN to withdraw this amount from my bank account
every month and have enclosed a cheque marked “VOID” so
that OWN can arrange the monthly withdrawal from my bank
account. I understand that I may change this amount or cancel
at any time by notifying OWN in writing with 30 days notice.
Signature
__________________________________Date________________
Rev Feb. 2008