Membership Application

Application for Membership
(To become a member, print out and complete this form, and mail with your cheque to the address below. Thank you!) Download a copy of this form here

A cheque in the amount of $75. must accompany this application which must be submitted by January 31 of each year.

Name: ______________________________________________________

Address: ____________________________________________________

City:____________________________ Postal Code: ________________

Phone: _____________ E-mail Address ___________________________

Why do you want to become a member of Second Chance Wildlife Sanctuary?

______________________________________________________________

______________________________________________________________

I agree to comply with all rules and by-laws of Second Chance Wildlife Sanctuary. I understand that it is the member’s responsibility to assist this organization by undertaking duties to benefit the organization.

Applicant’s Signature _____________________ Date: _________________

Please note “membership dues” in memo section of cheque.

Send completed application with cheque to:

Second Chance Wildlife Sanctuary
2060 Concession Road 7
Pickering, Ontario L1Y 1A2

For office use only:  

SCWS No. __________

Date of Issue _____________

Expiration Date ____________________

 Board Member _________________________

Board Member _________________________

In accordance with the by-law and constitution of Second Chance, only members of Second Chance will be allowed to vote at the AGM.