ONTARIO BIRD BANDING ASSOCIATION

MEMBERSHIP APPLICATION

Name: ______________________________________________________________________________


Address: ___________________________________________________________________________


City: __________________________________    Postal Code: ___________________________


Phone: (home)_____________________________  (work)__________________________________


Email: _____________________________________________________________________________


Annual Membership:

______   Life ($400)

______   Individual/Family ($20)

______   Student ($10)

Donation: $___________


I presently hold a banding permit: YES / NO     Permit Number:_____________________

Please make your cheque payable to ONTARIO BIRD BANDING ASSOCIATION and mail with this completed membership application form to:
Audrey Heagy, 273 Charlotteville Road Two, RR # 2, St Williams, ON N0E 1P0.