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Membership Application

Please accept my application / renewal for Membership in the Marquetry Society of Canada

Membership # (s)_______________

Mr. Mrs. Miss. Ms. ___________________________________________
                                                                                     First                                                Last

Street: ___________________________________________Apt# ________________

City:______________________________Province/State:_______

Postal Code:____________________

Country:____________________

Telephone:________________________ E Mail: ________________________

Date:______________
           Day - Month -Year

I am retired Yes No My occupation was / is _______________________________

The membership fee is New : $50.00 Renewal: $40.00

Family membership fee is New : $60.00 Renewal: $50.00

Your name will be added to the MSC membership list, which is only available to the current Executive members of the MSC. 
Contact the membership secretary : Alain Huard.

Updated January 2019