Membership Application Form

Membership Application Cowichan Valley Basket Society

Mission:Our objective is to ensure that no individual or family in the Cowichan Valley goes hungry either physically, spiritually or emotionally.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
E-mail*
example@example.com
Home Number
Cellular Number
Click here to see a copy of the CVBS Constitution and Bylaws
I acknowledge and understand this form to be an application for membership in the Cowichan Valley Basket Society.

I acknowledge that by signing this form, I am in agreement to the purpose of the Cowichan Valley Basket Society as stated in the Mission Statement .

At no time should a Cowichan Valley Basket Society Member act contrary to the best interests of the Society.
I agree to above statement by entering my name here.*
Please enter your name
Signature

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Signature Date

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Date
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Membership Application Cowichan Valley Basket Society