Membership Registration Form

CBRA Membership Application
CBRA Memberships are per-household.
by Credit Card or PayPalby cheque to the "Cadboro Bay Residents Association": $15 for membership in the current year (posted separately)
I wish to pay for:
prevnext( X )
CBRA Membership (auto-renewed annually until cancelled)($12.00CAD for each year)

CBRA Membership (one year only)($15.00CAD one-time payment)

CBRA Membership and $20 donation (single)($35.00CAD one-time payment)
renewing membershiptaking out membership for the first time
Full Name*

First NameLast Name
Spouse/Partner:

First NameLast Name
How many people in your household?
Email address:*
Membership includes automatic subscription to the Cadboro Bay News email bulletin. Is this acceptable, or do you prefer not to receive it?
Yes, thanksNo, thanks
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Comments
Should be Empty:

CBRA Membership Application