form

Please print, complete, and mail this form and your donation, membership, or subscription fee to:

CAC Alberta
P.O. Box 11171,
Edmonton, AB
T5J 3K4

or the completed form can be emailed to cacab@ecn.ab.ca, if paying by VISA or Mastercard. Use the subject "membership"; copy the form into your email message; complete the form and send.

Name                 ______________________________________
Street Address ______________________________________
City                   ______________________________________
Province           ______________________________________
Postal Code      _________________

Phone (____)__________________ Fax (____)_______________
Email _________________________

Date _____________________

How individuals and families can support the work of the Consumers’ Association

__ Regular Membership $25.00 for a yearly membership (includes the Consumer Watch Newsletter)

__ Special Membership $25.00 plus and an additional donation of $ _____ = $_______

How Organizations can support the work of Consumers’ Association

Organizations and companies are not eligible to become members – but are invited to support the important work of the Association through purchasing a subscription to our ConsumerWatch Bulletin.
____Corporate Subscription to Consumer Watch Bulletin for $125 dollars.

Individual or organization PAYMENT OPTIONS – cheque, VISA or Mastercard (NEW)
1. Visa or Mastercard #____________________________Expiry date:_____________
Today’s date:___________________________________Total amount: $___________
Signature________________________________________
2. Cheque $ _____

PLEASE NOTE: Membership, donor and subscription lists are not shared or sold outside the organization. VISA and Master Card numbers are not stored electronically, and email applications will printed and deleted. Receipts will not be provided unless requested in order to save postage. Donations to CAC Alberta are not eligible for personal income tax deductions due to our advocacy work.

11/11/03