CSANews 114

CSA Application Canadian Snowbird Association 1-800.265.3200 www.snowbirds.org Source code: E114 REV. 06/2018 Let us grow together The CSA is constantly looking for new members, just like you. Sign up five new members and get your next annual membership FREE. Download five applications from our website at www.snowbirds.org or photocopy the application below. Have five of your travelling friends become new and valued members of your association. Your efforts will be honoured with: • • Free Annual Membership • • Special Key Member Pin • • Your name published in CSANews Sign up five new members and become a Key Member of the CSA! DD MM YY MEMBERSHIP APPLICATION 180 LESMILL ROAD, TORONTO, ONTARIO, CANADA M3B 2T5 DD MM YY Signature ________________________________________ Date _ ___________________________________ Membership Number (for renewing members)_ _____________________________Language English Français Applicant’s Name___________________________________________________Date of Birth_______________ Spouse/Partner’s Name_______________________________________________Date of Birth_______________ Canadian Address___________________________________________________________________________ City_ ______________________________________ Province_______________Postal Code_ ______________ Telephone ( )____________________________ Cell ( )____________________________________ E-mail _ __________________________________________________________________________________ Winter Address_ ____________________________________________________________________________ City_ ______________________________________ State_ ________________ Zip Code_ ________________ Telephone ( )____________________________ Referring Member Name or Number_ _________________ Payment VISA MasterCard Cash Cheque (Make payable to: Canadian Snowbird Association) Credit Card # _ _______________________________________________ Expiry _ ______________ Membership per household (maximum 2 people) 1 Year $25 2 Year $45 3 Year $65 5 Year $99 Lifetime $325 I/we hereby apply for membership in the Canadian Snowbird Association (CSA) and, if accepted, acknowledge and/or agree as follows: 1) Membership dues are non-refundable and are renewable every June 30. 2) Information contained in this application may be used by the association for various purposes in accordance with privacy legislation including, but not limited to the following: a) Marketing purposes or research. b) Association-approved third parties as may be necessary. 3) The association will make reasonable efforts to ensure that we are advised of the purposes for which the information may be used. 4) The letters patent, by-laws, rules, regulations and policies of the association are binding. The Canadian Snowbird Association is in compliance with the Personal Information Protection and Electronic Documents Act (PIPEDA) of the Government of Canada. To exclude your subscription to the CSAN ews magazine, deduct $9.95 from the annual dues rate. Membership dues and fees are subject to change without notice. / / / / Special Action Fund Donation $20 $30 $50 $100 Other _______________________ 50 | www. snowbirds .org

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