Please print the following form, complete the details, and mail with cheque or money order .

Membership Dues:

Family:  $10

Senior Family [with at least one person over 65]:  $8

Single:  $5

Senior Single:  $4
Galetta Community Association

Attention: Membership
119 Darwin St.
Arnprior, ON  K7S 3G7

 

    I would like to become a member of the Galetta Community Association:

Name:

 

Spouse/Partner:

 

Address:

 

 

 

Telephone:

 

E-Mail:

 

Children’s Names:

 

Age:

 

Age:

 

Age:

 

Age:

Payment Enclosed*

$                     *No cash please

 

………………………………………………………….         Date: …………………….

[Applicant’s Signature]