Membership Registration Form

CBRA Membership Application
I wish to join or renew membership in the Cadboro Bay Residents' Association (CBRA) for an annual fee of $15.00 (if paying by cheque or cash), or $12.00 (if paying by automatic subscription online)
I am paying: *

by credit card or PayPal, securely, online (on submission of this form) by cheque to the "Cadboro Bay Residents Association": $15 for membership in the current year (posted separately), plus a discretionary donation
I wish to pay for:
prev next ( X )
CBRA Membership (auto-renewed annually until cancelled) ( $ 12.00 CAD for each year )

CBRA Membership (one year only) ( $ 15.00 CAD for each year )

CBRA Membership and $20 donation (single) ( $ 35.00 CAD one-time payment)
I am *

renewing membership—personal details as before renewing membership—with different personal details taking out membership for the first time
Full Name *

First Name Last Name
Spouse/Partner:

First Name Last Name
Email address: *
Membership includes automatic subscription to the Cadboro Bay News email bulletin. Is this acceptable, or do you prefer not to receive it?
E-bulletin?

Yes, that's fine, thanks No, thanks
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Comments
Should be Empty:

CBRA Membership Application