Membership Application


Please fill out and print this form, then send it, along with your payment to:

The Zoological Society of Montreal
1117 Ste-Catherine Street West, Suite 525
Montreal, Quebec
Canada   H3B 1H9

Where did you first hear about the Zoological Society? __________

_________________________________________________________________

Your field of profession? _______________________________________

Do you have a particular interest, e.g. birds, mammals, etc.? ___

_________________________________________________________________

Are you a member of any other conservation oriented organization?

_________________________________________________________________

Remarks: ____________________________________________________


__ Individual...........................  $35

__ Family (all living at same address).. $55

__ Cheque included.............. $__________


Name: ___________________________________________

Address: ________________________________________

City: ___________________________________________

Postal Code: ____________________________________

Tel.: (Home) _______________   (Office): _____________

Signature: ______________________________________

Date: ___________________________________________


Any donations to the Society (not including membership fees) are tax deductible, and we will issue a receipt.


This page last modified on: Thursday, January 5, 2006 23:24:29

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