Membre associé - AELRFC

Formulaire d’adhésion
Membre associé de l’Association de l’ELRFC
Nom : _______________________________________________________________________________
Prénom : ____________________________________________ Initiales : ________________________
Adresse : __________________________________ Ville : _____________________________________
Province : _________________________________ Code postal : _______________________________
Numéro de téléphone : __________________________________________________________________
Adresse courriel : ______________________________________________________________________
Membre militaire
Grade : _________________________________ Décorations : _________________________________
Régiment/Branche : ____________________________________________________________________
Membre civil
MDN
PSP
Autre : ____________________________________________________

J’accepte de recevoir des nouvelles de l’Association de l’ELRFC par courriel

J’accepte que mes coordonnées soient partagées dans le répertoire des membres de
l’Association de l’ELRFC
Signature : _________________________________________ Date : __________________________
Candidature recommandée par
Nom du membre régulier 1 : _____________________________________________________________
Signature : ___________________________________________________________________________
Nom du membre régulier 2 : _____________________________________________________________
Signature : ___________________________________________________________________________
Membership Form
CFLRS Association Associate Member
Name: _______________________________________________________________________________
First Name: ____________________________________________ Initials: _______________________
Address: __________________________________ City: _____________________________________
Province: _________________________________ Postal Code: _______________________________
Phone Number: _______________________________________________________________________
Email: ______________________________________________________________________________
Military Members
Rank: _________________________________ Decorations: _________________________________
Regiment/Branch: ____________________________________________________________________
Civilian Members
DND
PSP
Other: ____________________________________________________

I agree to receive news from the CFLRS Association by email

I agree to share my contact information in the CFLRS Association Member Directory
Signature : _________________________________________ Date : __________________________
Application recommended by
Regular Member 1: ____________________________________________________________________
Signature: ___________________________________________________________________________
Regular Member 2: ____________________________________________________________________
Signature: ___________________________________________________________________________