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Canadian Membership Application

Use this form if you wish to pay for your membership in Canadian Dollars. Fill in all appropriate information – use the address where THE HYMN and other mail communication should be sent – then click the “Create Application” button. Mail the custom generated form with your cheque to the address on the Application. Items marked * are required (if no e-mail or phone, enter 0 or none).

For gift memberships, choose “give a new membership” and the desired category (and other options if appropriate), then fill in your name and address, followed by the mailing information for the recipient.

I would like to start or renew my membership or give a new membership in the following category:
Individual ($85.00)
Individual (2 years: $160.00)
Retired ($75.00)
Student ($50.00)
Institution (School, Church, Library: $85.00)
$12.50 Joint membership HSGBI   ( Cancel selection)
$12.50 Joint membership IAH   ( Cancel selection)
Joint memberships are available only ot HSUSC in good standing.
Donor ($150.00 – one year membership)
Patron ($300.00 – one year membership)
Life Member ($1000.00)
Donors, Patrons, and Life Members help to underwrite the work of The Hymn Society.
($50.00 of the membership dues are for a one-year subscription to The Hymn, including $10 for mailing from the US to Canada)
Membership Dues: $
My additional gift to The Hymn Society: $
Amount Enclosed: $

Personal (or Billing) Information:

Name*
Street Address/P.O. Box*
 
City*
Province*
Postal Code*
Phone Number (with Area Code)*
E-mail Address*
Denomination*
 

Gift Recipient:
Name
Street Address/P.O. Box
 
City
Province
Postal Code
Comments or Special Instructions

Please check your input for accuracy then click the button

Note: The custom form generator may fail to work on some systems. If that is the case, simply print this page and mail it with your cheque to:

George Bell
2108 Kawartha Crescent
Mississauga, ON L5H 3P9