Westmount Historical Association Membership Form

Please enter the appropriate information in the boxes below, print this page, and submit by mail to the address below along with your payment:

Name:
Street:
City:
Province/State:
Country:
Postal Code:
Telephone:
Email:

Please choose membership category:

Individual $20
Family $30
Patron $150
Corporate $250

Donation in addition to my membership fee: $ (Charitable receipt)

Please note that our memebership year runs from 1 September through 31 August. Make cheques payable to the Westmount Historical Association and mail along with the completed form to:

Westmount Historical Association
P.O. Box 198, Station Victoria
Westmount, Quebec
CANADA H3Z 2Y6