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Who Belongs To The CPA?
    CPA 2008 MEMBERSHIP APPLICATION

    Membership is open to anyone with an interest in poetry, with affordable low
    annual dues. Membership is also open to literary organizations. The CPA
    Membership is based upon the calendar year (January 1st to December 31st).
    Membership includes a subscription to Poemata newsletter. Cheques should be
    made payable to the CPA (Canadian Poetry Association). A charge of $20.00
    will be levied against NSF cheques.

    Forward all general inquiries to: info@canadianpoetryassoc.com

    All cheques payable to:

    Canadian Poetry Association
    331 Elmwood Dr. Suite 4-212
    Moncton, NB, Canada E1A -1X6

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    Name:________________________________________________
    _____________________________________________________
    Address: _____________________________________________
    _____________________________________________________
    City/Town: _____________________________________________
    Postal Code: __________________________________________
    Phone:_______________________________________________
    E-mail: _______________________________________________

    (  ) Please include me in your email update submission list

    Membership Details

    (  ) $30.00 Regular Membership Rate
    (  ) $20.00 Student/Senior/Fixed income
    (  ) $40.00 International Membership
    (  ) $50.00 Association Membership Rate for Poetry Groups ( Cheque or Money Order only )
    (  ) $150.00 Library and bookstores affiliate membership (Cheque of Money Order)
    (  ) New Membership  
    ( )  Friends of the CPA Membership $50 and up (Cheque or Money Order)
    (  ) Renewal

    *note - no refund of membership.
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Student /Fixed
Income         
Regular
International
Vive la poésie!
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The CPA is a registered non-profit organization.
This material may not be published, broadcast, rewritten or redistributed in any form without
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