Chaffey's Lock and Area Heritage Society
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MEMBERSHIP

You may fill out this form on-line and then print it, or print out a blank form and fill it in by hand. Please mail it, with a cheque or money order to the address shown below
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Individual Membership: ($7.00)   Family: ($10.00) Business: ($25.00)
I would like to make an additional donation of towards the work of the Chaffey's Lock and Area Heritage Society. We can issue, upon request, a tax receipt for any amount above the membership fees. Please send me a tax receipt: Yes    No
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Please make your cheque or money order payable to "Chaffey's Lock and Area Heritage Society"

Chaffey's Lock and Area Heritage Society
1724 Chaffey's Lock Road, RR1
Elgin, Ontario K0G 1E0
email: suemaclat@sympatico.ca or tacton@kingston.net

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