Membership Application
2007-08 Season
Please print in block letters
Please complete, detach and mail with a cheque for
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 _________________________
