TORONTO AFRICAN VIOLET SOCIETY

Application For Membership

Please “Right Click” on this page to print this form, complete the information required, enclose you cheque or Money Order, and mail to:

Marilyn Crompton

1908 – 21 Overlea Blvd.

Toronto, Ontario, M4H 1P2

Membership Fee - $15.00 per year.

NAME_______________________________ Mr, Mrs, Miss, Ms

(Please Print)

ADDRESS________________________________Unit#_______

CITY____________________ PROVINCE/STATE__________

POSTAL CODE_____________________

TELEPHONE _______ ______________________

(area code)

FAX NUMBER _______ ______________________

(area code)

EMAIL _________________________________________

Thank You For Your Interest In The Club