Become a Member

Membership Application For FOW Canada And/Or Cash Donation

Yes, I would like to improve the quality of life of needy ostomates by applying for the following membership and giving a donation. Membership allows an individual to vote at the Annual General Meeting.

Individual Membership:   $30.00    ______    

Supporter: ______    

Chapter, Group or Association: $1.00 per member (maximum of 150.00)  _______

Please accept my donation of $ ____________

Name:     _________________________

Street:     _________________________

City:  _________________  Prov.:  ______

Postal Code:       ______________

Phone:        __________________

E-mail address:  _________________________________

Official receipts for tax purposes are issued

Please make a cheque or money order payable to FOW Canada

And mail to:

301 Benlock Road
Grafton ON
K0K 2G0

Or you can fill out the form below and once you click submit, a page will open with instructions on how to pay or donate.

Membership or Donation Form
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