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Queen's University

Membership Application Form: Queen’s Women’s Association

Please print out and complete in hard copy

If applying for membership under Category (d), please have your two sponsors sign the form. Membership fee is $60 ($30 for new members joining after December 31).

Name ______________________________________________________________

Address ____________________________________________________________


Telephone:__________________________ E-mail ___________________________

Would you be willing to receive occasional reminders or announcements via email or telephone? Please only agree to electronic mail if you routinely check your computer messages.

E-mail yes / no Telephone yes / no

If you wish, please indicate your connection with Queen’s University:

Your (and/or partner’s) Queen’s Department: ___________________________________

Your (and/or partner’s) Other Institution & Department:__________________________

Women joining under Category (d) (See Membership Eligibility) Proposed by:

1. _______________________________ (Signature: ________________________)

2. _______________________________ (Signature: ________________________)


Please send the completed form and membership fee of $60 (payable to Queen’s Women’s Association) to:

Membership Coordinator
144 Albert Street
Kingston, ON K7L 3V2

Kingston, Ontario, Canada. K7L 3N6. 613.533.2000