CANADIAN POETRY ASSOCIATION 2007 MEMBERSHIP FORM

PRINT OUT FORM

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

(  ) New Membership  

(  ) Renewal

(  ) $50.00 Association Membership Rate for Poetry Groups

The CPA Membership is based upon the calendar year (January 1st to December 31st)
no exceptions.
No refunds.  Membership includes a subscription to Poemata newsletter.

All cheques payable to:

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

thank you for joining..Brian Stevens, CPA Treasurer


CPA is a non-profit organization supported by members, the generosity of patrons and gifts from individuals. CPA welcomes donations on all
levels. A donation of $50 or more entitles donors to membership in the Friends of Canadian Poets and a complimentary one-year subscription
to Poemata. For further information on services and programs, or to make a donation, please contact us at the address below:

CPA
331 Elmwood Dr. Suite 4-212
Moncton, New Brunswick, Canada
E1A 1X6


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