Via Mail

Additionally a membership form can be mailed to you by contacting the office of the Canadian Club of Winnipeg at canadianclub@mts.net

Membership Form

The following electronic membership form can be used to submit your application to us. However a "print-and-mail/fax" version is also available in two formats:

Microsoft Word Adobe Acrobat

Membership Type:

New Membership

Renewal

First Name:
Last Name:
Title:
Position:
Business Name:
Business Address:
Business Postal Code:
Business Phone:
Business Fax:
Home Address:
Home Postal Code:
Home Phone:
Home Fax:
Email:
Website:
Notify Via:

These questions are optional and designed to gather information that will prove useful in learning more about the membership of The Canadian Club of Winnipeg. Thank you for taking the time to complete this section.

How did you hear about us ? Gender:
Age:
What speaker topics would interest you the most ?

Political

Business

Sports

Environment

Sales

Local Issues

Authors

Other

PaymentType

PayPal

97P
Enter the three characters here: