Membership Type: -- Please choose -- Individual (Annual) $25 Couple (Annual) $35 Individual (Lifetime) $200
Chapter: -- Please choose -- 1. Greater Toronto Area 32. Ottawa 68. Winnipeg 95. Vancouver 108. Edmonton Other No Chapter
Chapter Number: Chapter Location:
Prefix: --- Mr. Mrs. Ms. Dr. Fr. Rev. Sr. First Name: Last Name:
Street Address: City: Province: -- Please choose -- British Columbia Alberta Saskatchewan Manitoba Ontario Quebec New Brunswick Nova Scotia Prince Edward Island Newfoundland and Labrador Yukon Northwest Territories Nunavut Postal Code:
Phone: -- Type -- Mobile Home Work Fax Email:
Every member receives a free subscription to the Deaf Catholic magazine. Please choose how you would like to have it delivered:
Email (must provide email address above) Printed copy None, I don't want to receive the magazine.