Name *

First Name

Last Name

Phone

(###)

###

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

MEMBERSHIP OPTIONS *

Please select which membership option you are interested in:

General Membership $25

Senior/Student Membership $20

Family/Couple Membership $40

PAYMENT OPTIONS *

Please select which payment option you would prefer:

CHEQUE -- please address a cheque to "Wasagaming Community Arts"

E-TRANSFER -- please send an e-transfer to wasagamingartstreasurer@gmail.com.