Membership Application
2007-08 Season
Please print in block letters

Please complete, detach and mail with a cheque for
the amount appropriate for the category of 
membership you wish to:

The C. G. Jung Society of Montreal
5683 Monkland Ave Box 22515
Montreal QC H4A 3T4
Membership Category

Regular $40          ___

Student  ___      or Senior $25          ___

Newsletter subscription only, $25     ___


__________________________________________


Name ___________________________________

Street ____________________________Apt.____             

City ______________________________________   

Prov.  ______  Postal Code ______________
    
Email _________________________________

Phone ______________________

Fax _________________________