Western Canada Peer Training Society
1316 Pensacola Way SE
Calgary, AB T2A 2H2
sec.wcpts@gmail.com
www.wcpeertraining.ca
(587) 830-2742
Membership Registration Form
Name
*
First Name
Last Name
Email
*
example@example.com
Primary Phone Number
*
Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Preferred Method of Communication:
*
Email
Text / SMS
Primary Phone
Consent to Contact You
Yes
No
Email
Phone or Txt
Please Select Your Annual Membership Type
*
$5 - Volunteer Voting Member - In kind donation of 15 hours/minimum 5 meetings and activities per year plus AGM.
$20 Voting Member + Tax Receipt
$20 or More - "Friend of the Society" - non-voting membership, tax receipt
$100 or more - Community Partner - non-voting membership, tax receipt, recognition upon consent
$800 - Sponsor one practicum placement, non-voting, tax receipt, recognition
Membership Fee to Be Sent Via:
*
eTransfer (sent to sec.wcpts@gmail.com)
Cheque (mailed to 1316 Pensacola Way SE, Calgary, AB T2A 2H2)
Please Check Your Areas of Interest as a Volunteer Member
*
Community Development & Promotion (Social Media)
Fund Raising
Educator/Mentor/Content Development
Special Events
Administration/Website
Community Engagement/Practicing Peer Supporter
Policy Writing
Not Applicable (Not a Volunteer Membership)
By submitting this form as completed, I am agreeing to applying for membership within the Western Canada Peer Training Society (WCPTS) and to discussions with the WCPTS Membership Committee, regarding my application for Membership.
*
I agree
I disagree
I reserve making a choice at this time pending more information
Date of Completing this Form
*
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Month
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Day
Year
Date
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