Ontario PC Party - Membership Form
Membership in the Ontario PC Party is open to any resident of Ontario who is 14 years of age or over and who agrees to uphold the constitution of the Ontario PC Party.

PLEASE NOTE: All Memberships purchased between Oct 1st and Dec 31st will be valid for the
2007 membership year.

Please do not use the "return button" until finished!

We encourage you to join the Ontario PC Party Riding Association of Stormont,
Dundas, & South Glengarry. Should you wish to pay by cheque or cash, please
complete the form below and should you wish to pay by credit card please
click

Select... Mr. Ms. Mrs. Miss. Dr. Hon.

First Name:		Last Name:
Address:		City/Town:
Postal Code:		Occupation:

Date of Birth:

Month:

Day:

Year:

Home Phone:		Business Phone:
Home Fax:		Business Fax:
Home E-Mail:		Business E-Mail:

Membership in the Stormont, Dundas & South Glengarry PC Riding Association expires every year on December 31. To avoid a lapsed membership, please
contact Priscilla Franklin , Membership Secretary, 577-TORY or send a $10.00
cheque to Priscilla at the riding address:

PCPO SDSG Riding Association
Membership Secretary
P.O. Box 21008
31 Ninth Street East
Cornwall, Ontario
K6H 7L8