General Membership Application Application Date(Required) MM slash DD slash YYYY Name First Last Contact Number(Required)Email(Required) Enter Email Confirm Email Address(Required) Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Are you an Inclusion Parksville employee?(Required) Yes No Are you a parent or caregiver of someone who receives services from Inclusion Parksville?(Required) Yes No Have you previously been a Member of this society?(Required) Yes No By applying for membership, I agree to Inclusion Parksville’s Constitution and Bylaws.(Required) Yes No What interests you in becoming a Member of Inclusion Parksville?(Required)What skills/experience would you bring to Inclusion Parksville if you were to become a Member?(Required)Donation Amount (this is not required in order to become a general member)Donated by Cheque - Mail - Inclusion Parksville, 249 Hirst Avenue West, Box 578, Parksville BC, V9P 2G6 Cash and Debit - In Person - Inclusion Parksville, 249 Hirst Avenue West, Box 578, Parksville BC, V9P 2G6 - 09:00am-03:45pm Credit - Call - 250-905-0131 E-Transfer - bookkeeper@inclusionpv.org
