IACHC Membership 2015

Innisfil Arts, Culture and Heritage Council
P.O. Box 7143
Innisfil, ON
L9S 1A9
www.iachc.ca

* indicates required

Name: Email: Comment:

Email Address *

First Name *

Last Name *

Address

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

Website

Primary Phone No

( ) -

Are you intested in volunteering opportunities?

What are your Visual Arts interests?

What are your Culture & Heritage interests?

Membership Levels *

Method of Payment

PayPalCheque

Notes

Mail cheque to P.O. Box 7143. Innisfil, Ontario L9S 1A9

Status of Payment *

PaidNot PaidPayment Pending

Date *

Preferred format

HTML Plain-text

IACHC Membership 2016/17