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:
FOWCanada
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.
