Membership Form: WOMEN AWARE / FEMMES AVERTIES

Nom / Name
*Adresse / Address
*Telephone
*Courriel / Email
example@example.com
Pourquoi voulez-vous devenir membre de Femmes Averties ? Why do you want to become a member of Women AWARE?
Why do you want to become a member of Women AWARE?
Signature

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Date

MonthDayYear
Date
* Veuillez fournir vos coordonnées afin de recevoir de l’information concernant des assemblées des membres et d’autres activités. Les renseignements personnels seront confidentiels.

* Please give your coordinates to receive information about membership meetings and other activities. Personal information will be kept confiential.
Should be Empty: