Join Achilles Canada

Membership Application

Name:
Address:
City:
Province:
Postal Code:
Home Phone:
Work Phone:
E-Mail:
Date of Birth:
Sex: M F
Occupation:
   
How would you like to become involved?
Member with Disability
Able Bodied Member
Volunteer
   
If volunteering, what areas would be of interest to you? (please check all that apply)
  Special Events
  Running Guide/Companion
  General Administration
  Fund Raising
   
 
   
For more information, please contact:

Brian McLean
119 Snowdon Avenue
Toronto, ON M4N 2A8
E-Mail: bmclean@achillescanada.ca
Tel: 416-485-6451 Fax: 416-485-0823