Please print out and complete this membership form
New Membership Rates (above) effective March 29, 2005
Name________________________________
Organization_____________________________
Address___________________________________________________
City____________, Province___________________ Postal Code____________________
Phone_____________ Fax____________ E-mail________________
ARTS COUNCIL - WINDSOR & REGION THANKS YOU FOR YOUR SUPPORT
and return it with your payment to:
Arts Council - Windsor & Region (ACWR)
1942 Wyandotte Street East, Windsor, Ontario N8Y 1E4
Phone: (519) 252-6855 Fax (519) 252-6553 E-mail: acwr@mnsi.net
Please accept my application for membership. I have checked the appropriate box below.
Individual - $30
Family - $45
Senior - $20
Student - $20
Non-Profit - $45
Business - $125
LIFETIME - $250
In addition to my membership, I would also like to make a tax deductible donation of
$ _________ to the Arts Council - Windsor & Region.
I do not wish to obtain a membership at this time but would like to make a
tax deductible donation of $ __________ to the Arts Council - Windsor & Region.