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DisAbled Women's Network: DAWN ONTARIO

Membership Form


In principle and practice, DAWN Ontario values and seeks a diverse membership. There shall be no barriers to full participation in this organization on the basis of gender, race, creed, age, sexual orientation, national origin, disability, or class.

If you are in a position to afford voluntary membership dues, you may mail your cheque or money order to:

Please print, complete, and mail membership form, along with your cheque or money order to:

DAWN Ontario
Box 1138
North Bay, ON   P1B 8K4
CANADA

Please email us for further information



ANNUAL FEE:

[ ] $10 - Individual [ ] $25 - Consumer-Run Group or Networking [ ] $50 - Government [ ] $50 - Service Agency Name: _______________________________________________ Organization: _______________________________________ Address: ____________________________________________ ______________________________________ Apt # ________ City: _______________________________________________ Province: _________________ Postal Code _____________ Daytime Phone Number: (_____) _______________________ Evening Phone Number: (_____) _______________________ Email: _____________________________________________ URL: ________________________________________________

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