501 Eighth Avenue S. Kenora, Ontario P9N 3Z9
Phone 807 - 467-5225 Fax 807 - 467-5247
| To take membership online, click on the icon to the right., enter Kenora Association for Community Living, click on search, click on go, Select Donate Now, Enter minimum of $10, Select 1. General Fund, Type Membership Fees as a Message, Continue and add details of payment method, including address etc, Finally choose disclose to Association under privacy options. |  |
Name:
Address: __________________ Postal Code: __________________
Work Phone:_____________ Home Phone: ___________________
Email address:_____________________
Membership Fee: $10.00
Please check one:
_____GENERAL MEMBERSHIP: I am not an employee of KACL, nor have I been employed during the past two years by the Association or other local Associations, Regional Councils, Provincial or National Associations, with which it is affiliated, or a parent, spouse, including common-law spouse, child or sibling of such a person.
_____ASSOCIATE MEMBERSHIP: I am currently employed by KACL, and/or I have been employed during the past two years by the Association or other local Associations, Regional Councils, Provincial or National Associations, with which it is affiliated, or a parent, spouse, including common-law spouse, child or sibling of such a person.
I would like a monthly email detailing news from the association YES___NO____ EMAIL____________________
I would like my name and address distributed as a member of KACL when requested. YES __ NO _____
Please complete and bring to KACL central office, or mail to
KACL, 501 Eighth Ave. S. Kenora, Ontario, P9N 3Z9
Office Use Only:
Receipted:_____________2010 by ________________ # ___________
Membership Card Issued ______________ Card # ___________