PHS Membership Form

Petawawa Horticultural Society

Membership Form
The PHS values your information. We do not publish, share, sell, or exchange member information or their names with any group, organization or business.
Name*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
E-mail*
example@example.com
Phone Number:*

Payment Options*

$10.00 CAD ( INDIVIDUAL MEMBERSHIP )$15.00 CAD ( FAMILY MEMBERSHIP )$20.00 CAD ( BUSINESS MEMBERSHIP )
Please enter the name of the business
Name of Business
Number of Family Members
Total Family Members INCLUDING Yourself
Name of Family Member #1
Name of Additional Family Member (not yourself)
Name of Family Member #2
Name of Additional Family Member (not yourself)
Name of Family Member #3
Name of Additional Family Member (not yourself)
Name of Family Member #4
Name of Additional Family Member (not yourself)
Name of Family Member #5
Name of Additional Family Member (not yourself)
You may pay for your subscription / donation

via e-transfer or cheque

payable to petawawahortpay@gmail.com

or via cash

For yearly subscriptions, by clicking the "Submit" button you are submitting your online application for PHS membership. Once we receive your payment, we will contact you about your membership.

Thank you!
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Petawawa Horticultural Society