Core ($30)
Affiliate ($30)
Individual ($20)
Name: _________________________________________________
Organisation: _________________________________________________
Address:_____________________________________________
Tel: ___________________________
Fax: ___________________________
Email ___________________________
Please mail your payment to:
400-257 rue Queen, Sherbrooke QC J1M 1K7
For more information, call (819) 564-9595 / Toll free: 1-877-964-0409.
