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ETHNIC
PRESS COUNCIL OF CANADA
Canadas
other voices
MEMBERSHIP APPLICATION
SURNAME
..
NAME
..
ADDRESS
Telephone
Numbers
Business:
( )
Res : (
)
.............
Citizenship
:
Canadian : Yes
.
No
OTHER
Representing
Publication or Electronic
Media
...........
Language
.
Position
.......
Profession
:
..
Brief
professional experience
:
..........................
.....................
.........................
Sponsored
by :
1
.
2
..
I
.
do certify and assure that I have no past or outstanding criminal
convictions in Canada
Applicants
signature
For Internal Use Only
Accepted.
: Yes
..
No :
Date
..
Comments
:
.
Admissions
Committee :
1.
Signature:
.. 2. Signature
..
3.Signature
...
Membership
Fee is $ 25.00
per annum.
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