APPLICATION FOR WOODPENS' CLUB MEMBERSHIP

and MEMBERSHIP RENEWAL

Period: Fall 2019 to December 31, 2020

NAME: _________________ SPOUSE: ____________

Mrs./Ms./Mr.

ADDRESS: ______________________________________________

CITY: _________________POSTAL CODE: ______

TELEPHONE: _________________

Department(s) worked _______________# of years _________

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I wish to become a Woodpens' Club Member.

New Member____Membership Renewal______ (Please indicate)

SIGNATURE: ____________Date______________

Membership Fee is Single $15.00 Couple $18.00

PLEASE MAKE CHEQUE PAYABLE TO: WOODPENS’ CLUB

Mail your cheque to: Woodpens’ Club, Unit 513 - Retail Level

650 West 41^st Avenue, Vancouver, BC V5Z 2M9

Revised March 12^th 2020