wspcr logo

The Westcoast Society
for the Protection and Conservation
of Reptiles

Membership Application Form
You can compile this form online and send the fee. Or you can print out the application form, compile it, and send it along with the fee to: W.S.P.C.R. - 6200 McKay Ave. Box 625 - Burnaby, BC V5H 4M9 - CANADA
Your membership will become active only once the membership fee has been received (processing time by mail is usually around 3 weeks).

NEW MEMBER: RENEWAL: CHANGE OF DATA:

Full Name: Phone: E-mail:

Address:

TYPE OF MEMBERSHIP

INDIVIDUAL ($25):   FAMILY ($30):
 
I sent or will send the membership fee by mail:   I gave the membership fee to a WSPCR officer: Specify:


NEWSLETTER OPTIONS

I choose to receive the Newsletter by e-mail (at the above e-mail address):
I choose to receive the Newsletter by normal mail:


T-SHIRT SIZE

(every membership entitles to receiving one free WSPCR T-shirt and to a discount on any other purchased)
S: M: L: XL: XXL:


INTERESTS

Snakes: Lizards: Turtles: Husbandry:
Education: Conservation: Rescue: Social Activities:
Other: