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).
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:
144 Albert Street
Kingston, ON K7L 3V2