AMHGS MEMBERSHIP FORM

Please complete, email or print and mail the form below.
Include a check or money order for the correct amount to:

Check or Money Order payable to ATCHA or Call (902) 648-2493 to pay by Credit Card. (US residents are requested to pay in US funds to cover additional mailing costs)

Fill in the Form below:
Last Name*		First Name*
Address*
City*		Prov./State*	Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory
Zip* Postal Code		Country*	Canada United States
Phone*	- -	Email

Membership Type:
New Membership:
Renew Membership:
Check the membership you wish to purchase:
I enclose:	Year 2007 2008 2009 2010 2011 2012 2013 2015 2016 2017 2018 2019 2020	$30.00 for an individual membership
I enclose:	Year 2007 2008 2009 2010 2011 2012 2013 2015 2016 2017 2018 2019 2020	$35.00 for a family membership
Your cancelled cheque will be your receipt. Receipts and membership cards are issued only if requested below.
Receipt:
Membership card:
Contact me for meetings:
Do you know someone who would enjoy reading The Argus and might be interested in joining our society? If so, let us know and we will send them a complimentary copy of our newsletter and extend an invitation to them to join.

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