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Membership

Mon, 2010-01-11 12:56 — bruce.donovan

 

SESCI LogoPrintable Membership Order Form

__________________________________________________________________________
Title: Mr.   Ms.   Mrs.   Dr.   Other:
First Name(r): Last Name(r) : 
Organization:
Department:
Mailing Address(r):
City(r):
Province/State(r):
Country(r):
Postal Code/Zip Code(r):
Home Phone(r): Work Phone: 
Fax:
Personal Email(r):  
Organization Website: http://www.
  (r): Required fields

______________________________________________________________________________________

Please indicate category chosen:

* This is a one-time contribution; payment may be made over a three year period and a tax receipt issued.

** Available on request.

Different categories of SESCI membership provide varying benefits but all members receive member rates to SESCI Conference and events.

SESCI's membership list is not sold.

Full Time Student $20

Senior Citizen (Over 65) $40

Individual $100

Library $300

Corporate (5 or less employees) $200

Corporate (6 or more employees) $500

Supporting Corporate $3,000

Sustaining Lifelong (Individual)* $5,000

ISES (Intn'l Solar Energy Society)**

Payment: Cheque/Money Order Visa/Mastercard

Amount Included: Cdn$

_____________________________________________________________________________________

Credit Card Payment Information:

Name (as shown on Credit Card):

Address where credit Card Statements are sent (only fill out if different from above)

Credit Card number:   

Expiration Date:  Month/Year: / Security Number (Back of Credit Card):
_____________________________________________________________________________________

 

Signature: ___________________________________________________________________________

Email: bruce@techonfoot.com
Web: www.sesci.ca

Please print and return to:
Solar Energy Society of Canada Inc.
207 Bank Street, #173
Ottawa, ON
Canada 


Credit Card Paymenst can be faxed to 
1 (819) 775-4315

 

Copyright 2007 Solar Energy Society of Canada Inc.