~ Membership Form ~

           
           
Name: ____________________________________________________
         
Address: ____________________________________________________
         
City: ____________________________________________________
         
Province: ____________________    Postal Code:   _______________
         
Phone: Home: _____________________________  
         
Work: _____________________________  
         
Fax: ____________________________________________________
         
Email: ____________________________________________________
           
           

Volunteer Activities: Please indicate which activities are of interest to you

Fostering: _____     Fundraising: _____     Transportation: _____ 

Telephone Work: _____     Craft Making: _____     Special Events: _____


 

Please return this form - along with your cheque to...

B.A.R.K.
c/o Carol Thompson
117 Whitetail Dr.
Carp, K0A 1L0
613-831-9805

           
~ Please make your cheques payable to B.A.R.K. ~

 

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