MEMBERSHIP APPLICATION FORM
The membership fee includes conditional access to the Thompson Rivers University library, bookstore and Elder College activities. (Individual course fees are expected to be modest and will be set on a course to course basis, essentially to cover direct administration costs only.)
THE FEE FOR THE __________ACADEMIC YEAR IS $10.00.
Date ______________________
Name _____________________________________________________________________
Mailing Address _____________________________________________________________________
City _____________________________________ Postal Code____________________
New Member ____________ Membership Renewal _______________
Telephone __________________ E-Mail ______________________________________
Fax ____________________
Birthdate: Y_______M_______D______ Female_______Male_______
METHOD OF PAYMENT
___ Cheque made payable to the Cariboo Chilcotin Elder College (please do not post-date cheques).
___Cash
THIS FORM MAY BE MAILED TO THE ADDRESS BELOW.
Are you interested in becoming an Elder College Volunteer? Yes ___ No ___
Please indicate in which areas you would like to volunteer (i.e. committee member, instructor, course assistant, etc.)
____________________________________________________________________________________
____________________________________________________________________________________
Other Comments ____________________________________________________________________________
____________________________________________________________________________________
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Mailing Address: Cariboo Chilcotin Elder College, Thompson Rivers University, 1250 Western Avenue, Williams Lake, BC, V2G 1H7 Telephone: (250) 392-8180
Website: http://www.cceldercollege.com Email: secretary@cceldercollege.com
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FOR OFFICE USE ONLY:
Membership Card Given ___ Newsletter Given ___ Data ___
Place completed form in Elder College File. |