MEMBERSHIP APPLICATION FORM


Please fill in all of the appropriate fields in the form below, print it out and mail it with a cheque to:

Marie Gauthier (Membership)
c/o Ottawa Orchid Society
13, Sandringham Court
Ottawa ON K2J 2H9

Dues are $25.00 per year (Sept 1 - Aug 31). Make all cheques payable to the "Ottawa Orchid Society."

First Name:
Last Name:
Spouse:
2nd First Name:
2nd Last Name:
Address:
Apt #:
City:
Province/State:
Postal Code:
Home Phone Number:
* Work Phone Number:
* Fax Number:
E-mail Address:
Comments:

* Indicates fields that are optional