Svenskbyborna Society Membership Application

 

 

Name(s):_________________________________________________________

              

            ___________________________________________________________

 

            ___________________________________________________________

 

Svenskbyborna family name:     _____________________________________

 

Mailing address:     ________________________________________________

 

                                    ________________________________________________

 

City:   ___________________________________________________________

 

Province/State:       ________________________________________________

 

Postal/Zip Code:     ________________________________________________

 

Phone Number:      ________________________________________________

 

Email address:        ________________________________________________

 

 

Please note:  The Society would like to print a membership directory so members can contact each other directly.  Please check the box below if you agree to have your name included in the directory.  Your contact information will not be distributed to third parties.

 

 Yes, I give my permission to print my contact information in a membership directory to be distributed to members only. 

 

Enclose a cheque for $25 and mail to:

 

Svenskbyborna Society

Box 238

Ryley, AB T0B 4A0