Native Orchid Conservation Inc.
Membership/Donation Form

I wish to begin or continue my membership in NOCI. A Group Membership is for organizations. For the benefits of Group Membership please call Florence at 633-2138 or email at MembershipChair.

Junior is under 18 years old.

  Individual  ____ @ $15.00 __________
  Junior ____ @ $0.00 __________
  Group ____ @ $40.00  __________

I wish to donate to help save endangered plants and habitat.

  [ ] $25.00   [ ] $50.00   [ ] $100.00   [ ] Other   Donation Amount __________
    Total __________

I wish to save trees by giving up paper newsletters;  I have verified that I am receiving
electronic notifications, and I'm willing to receive notice of meetings in only that way.

  [ ] YES   [ ] NO

Name(s): __________________________________________________________
Address: __________________________________________________________
  __________________________________________________________
Signature: __________________________________________________________
Optional Information:
Phone: __________________________________________________________
E-mail: __________________________________________________________
Occupation: __________________________________________________________
Interests: __________________________________________________________
Volunteer? __________________________________________________________
How did you first
learn about NOCI?  
__________________________________________________________

A tax-receipt for your donation will be issued in February;  our Tax-Nbr is  86816 7198 RR0001.

Mail, with cheque payable to Native Orchid Conservation Inc, to:

  Florence McCoy, NOCI Membership Chair
Box 28A, RR 2, Stn Main , Winnipeg R3C 2E6