To become a member of the Association

Print this form, fill it out and send with your payment (cash, cheque or money order) to the address indicated below the menu on the left. Make the cheque or money order payable to the "Association des Boudreau Inc." A membership card will be sent to you soon after we've received your order.

Information personnelle:

 
Name  Surname  Birth Date (DD/MM/YYYY) 
Member 
     
Spouse 
     

 

Address:  

Street (apt.):

 

P.O. Box:
Site: 
City/Town/Village, Province/State :

Postal Code:

 

Telephone:

 

Home:
Work:
Email:

 

Children: Only register those children still living at home

Name 
Birthday (DD/MM/YYYY)
   
   
   
   
   
   

 

Registration Fee
Single  $10.00 Cdn  $10.00US
Family  $15.00Cdn  $15.00US

     Amount: ___________

      Date: ______________