OttScott

The Scottish Society of Ottawa

Membership Application Form
Number of members to renew or join:*
Membership Total
Includes HST
Member 1 Information
Name

First NameLast Name
Telephone Number :

Area CodePhone Number
E-mail (personal)
Membership Type*

New MemberRenew Membership
Member 2 Information
Name

First NameLast Name
Telephone Number :

Area CodePhone Number
E-mail (personal)
example@example.com
Membership Type*

New MemberRenew Membership
Member 3 Information
Name

First NameLast Name
Telephone Number :

Area CodePhone Number
E-mail (personal)
example@example.com
Membership Type*

New MemberRenew Membership
Member 4 Information
Name

First NameLast Name
Telephone Number :

Area CodePhone Number
E-mail (personal)
example@example.com
Membership Type*

New MemberRenew Membership

Membership Total*

CADIncludes HST 13%

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Once you submit your application, we will contact you shortly to complete your membership application.

Thank you!
Should be Empty: