Join Our Membership

Application Forms are available by:
  • hardcopy at the Main Office - 249 Hirst Ave W., Parksville

  • download CLICK HERE, then print, complete and return to:
    Inclusion Parksville Society, 249 Hirst Ave. W., Parksville, BC V9P 2G6

  • completing online using the form below.

 

Fill Out Our Inclusion Parksville Membership Application Form Online!

Inclusion Parksville Society Online Membership Application

Date of Application
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Given Name(s)
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Family Name(s)
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E-Mail
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Home Phone
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Cell Phone
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Mailing Address
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Town/City
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Province
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Postal Code
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Are you currently an Inclusion Parksville Society employee?
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Are you a parent or caregiver of someone who receives services from Inclusion Parksville Society?
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Have you previously been a member of this society?
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What interests you in becoming a Member of Inclusion Parksville Society?
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What skills/experience would you bring to Inclusion Parksville Society if you were to become a Member?
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Memberships expire on March 31st annually. Membership application fees are by donation:
Payment Options: Cash or Cheque.
Submit payments to the Inclusion Parksville Society Office at:
249 Hirst Avenue West, Box 578, Parksville, B.C. V9P 2G6
Make a Donation Today!
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Different amount:
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Total
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Please prove that you are a human(*)
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Scent Free Zone
Inclusion Parksville Society is a scent free zone; scented products (may include cologne/perfume, hair products, body sprays and lotions, cleaning products, laundry supplies, highly scented soaps and deodorants) should not be worn or used on the premises.
CARF International
Inclusion Parksville Society is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). To learn more, please visit CARF Canada's website.
Donate Now - Canada Helps
We sincerely appreciate your cash donations. 100% of the money we raise goes to our local programs. Click here to DONATE, VOLUNTEER and/or SPONSOR