APPLICATION FOR MEMBERSHIP

HOW TO SUBMIT YOUR PAYMENT of $105

Initiation FEE is $25 and the annual DUES are $80

If Paying by cheque, mail it to:

Women’s PROBUS Club Kitchener Westmount Attention Treasurer
5-420 Erb St. W. Suite 435
Waterloo, ON N2L 6K6

If paying by e-transfer, send it to: treasurerwpckw@gmail.com

If joining in Jan, Feb or Mar, your DUES will be prorated to $60 instead of the normal $80, so together with your initiation FEE of $25, your total for joining will be $85 instead of $105.

If joining in Apr or May, your DUES will be prorated to $45 instead of the normal $80, so together with your initiation FEE of $25, your total for joining will be $70 instead of $105.

If joining in June, you may attend the June meeting as a guest, and then pay the full $80 in DUES for the following year, so together with your initiation FEE of $25, your total for joining will be the usual $105.

HOW TO SUBMIT YOUR APPLICATION

You can fill out the form below and click the submit bottom at the bottom to email it directly to the Membership Chair

You can click here to go to the “paper version” of the Application Form, print it, fill it out and mail it to:

Womens PROBUS Club Kitchener Westmount Attention Membership
5-420 Erb St. W. Suite 435
Waterloo ON N2L 6K6

You can click here to go to the “paper version” of the Application Form, print it, fill it out and then scan the completed application form and email as an attachment to:

membership@wprobuskw.ca

First Name

Last Name

Phone Number

Address (your Street, City, and Postal Code)

Birthday (just month and day)

Emergency Contact

Relationship

Phone Number of Emergency Contact

Your Former Vocation

How did you hear about our PROBUS Club

Did a current member invite you to join?

If you are transferring from another PROBUS Club, name of Club and Year you joined.

I submit my application for membership to the Women’s PROBUS Club Kitchener Westmount

Once you join our Club, you will be issued a name badge.
How would you like your name to appear on your PROBUS NAME BADGE?

Please PRINT YOUR NAME as you want it to appear in the PROBUS DIRECTORY.
It will show as Last Name (s), First Name (s) and will be alphabetized in the directory by the first letter of your “Last Name(s)”

PERMISSION FORM

As a result of the changes in the Government’s Privacy Act, the Women’s PROBUS Club Kitchener Westmount is requesting signed permission from its members to include their contact information and photograph in our Membership Directory (only distributed to members) and in the “members only” section of our Website.

****** I agree to have my contact information and photograph included in the Women’s PROBUS Club Kitchener Westmount Membership Directory and Website. I understand that these locations are for the sole use of Club members and will not be used for business or commercial purposes