return to home... Please fill out or print this form and send cheque to West Quebecers Regional Association of West Quebecers Membership Form Personal Information First name: Last name: Address: City/Province/ Postal Code Telephone number: e-mail:     Please list the names of others included in Family Membership (for voting purposes at the Annual General meeting): Choose one membership fee in this section   Individual membership 1 Yr. $10   or 3 Yr.  $25  Couple (2 memberships) 1 Yr. $20 or 3 Yr.  $50  Family (3 or more)        1 Yr. $25   or 3 Yr.  $65  Corporate membership 1 Yr. $25   or 3 Yr.  $60      I would also like to have a 1 Year subscription to the West Quebec Post ($25 when bought separately)   add only $15    I would also like to have a 3 Year subscription to the West Quebec Post ($75 when bought separately ) add only $45    I would also like to make a donation of:                     TOTAL AMOUNT: I will be sending along a cheque made payable to The Regional Association of West Quebecers by mail.     Please return this completed form to: The Regional Association of West Quebecers 53 Principale St. Gatineau, QC J9H 3L4 Tel: (819) 682-9602 Fax: (819) 682-4033 Toll free: 1 877 733-0177 E-mail: wq@magma.ca

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