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CPF Nova Scotia Branch

8 Flamingo Drive

Halifax. N.S.

B3M 4N8

 

MEMBERSHIP APPLICATION FORM

CPF ALLOWS TOW NAMES PER FAMILY, OVER  THE AGE OF 18 YEARS, AS VOTING MEMBERS.

O    Change of Address        O    New Membership       

O    Renewal : Membership #__________________

 

 

MEMBER INFORMATION

 

Name___________________________________________________________

 

Second Adult in the Household________________________________________

 

Street___________________________________________________________

 

City____________________Province__________Postal Code______________

 

Telephone_______________E-mail___________________________________

 

School Board_____________________________________________________

 

School__________________________________________________________

 

Local CPF Chapter/Section______#3515__________________________

 

Occasionally, the CPF membership-list may be available to other groups/agencies to offer members benefits of education-related information. Use of the list will be carefully regulated and only permitted under a contract specifying confidentiality and one-time authorization.

O   If you do not want to recieve mailings other than directly from

        CPF, please  check this circle

 

 

        Thank you for your support.

        (CPF Charitable Reg. No. 11883 5131 RR0001)

MEMBERSHIP FEES

1 YEAR- $25.00_________________

3 YEAR- $60.00_________________

1 YEAR (AMO)- $60.00___________

DONATION____________________

TOTAL _______________________

65% of your membership fee is for your local Chapter and %35 of the fee is divided between the National office and your provincial/territorial branch.

 

DONATIONS

Your gift of support to CPF is also welcomed

Donors are recognized into 3 categories:

O BENEFACTOR -gifts of $250 and more

O PATRON -gifts of $100 up to $250

O SUPPORTER -gifts of up to $100

Every donation is important to us. However, due to cost, receipts will be issued at the end of each year, for donations of $10 or more, unless one is requested

AMO

Associate Member Organization is available to organizations who endorse the goals of CPF. The AMO is entitled to newsletters and other designated reports or mailing. AMO status confers no right to vote

PAYMENT OPTIONS

O VISA   O MASTER CARD O CHEQUE ENCLOSED

 

CARD #_________________________________________

 

EXPIRES________________________________________

 

DATE__________________________________________

 

SIGNATURE_____________________________________