BEGINNING AND RENEWING* YOUR MEMBERSHIP in the World Federalist Movement - Canada

Choose one category of membership:

• Contributor – $150 ___ • Household – $60 ___ • Individual – $40 ___

• Limited Income – $15 ___

(On average, we need $150 per person annually to carry the organization.
“Limited income” is for members living below the poverty line.)

Membership fees are to be paid to World Federalist Movement - Canada.
*If renewing, please tell us if anything has changed.

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Your Name: (First)______________________________(Last)________________________________

Your Address: _____________________________________________________________________

City: ____________________________________Province: _________________________________

Postal Code: _________________________________________________

Telephone Number: ___________________________________________

Email Address: _______________________________________________

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Sustaining the World Federalists: Additional donations

If you wish, please add a donation:

Donate to the World Federalist Movement - Canada
(There is no charitable tax receipt with this choice): $ __________ .
Your cheque should be issued to WFM-C.

Donate to the World Federalist Foundation
(This choice gives you a charitable tax receipt): $ __________ .
Your cheque should be issued to WFF.

Thank you for considering an additional donation.

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Print and Mail this coupon and your cheque(s) to the WFM-C office.
(You may also pay by credit card. Call 613-232-0647.)

World Federalist Movement - Canada / World Federalist Foundation,
Suite 207, 145 Spruce Street,
Ottawa, Ontario K1R 6P1

Thank you.