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2016-17 Registration Form

Note: The fields with an asterisk are required.

If you prefer you can download registration form:
.pdf format.docx fromat.doc format

Print it and mail along with the fee to the address indicated on the form.

Note: The form is submitted only if you see the statement:

Thanks! Your submissions have been received.

 

First Name*
Last Name*
(For Returning Members) Any changes to your personal information since last year?*
   
Address*
City*
Province*
Postal Code*
Home Phone #*
Cell Phone #
Email address*
Degree (1)*
University (1)*
Degree (2)
University (2)
Degree (3)
University (3)
Membership Type:
  • Full - $110
    A graduate from an accredited university or equivalent qualification from an institution of higher education or who have earned a professional designation or qualification that currently requires a university or college degree or diploma. 
    A woman who does not meet these criteria but supports the purposes of CFUW is also eligible for membership in the Club.
    Dual - $40
    Please specify the other CFUW club to which you are paying dues.
  • Student - $55
    Full-time university or college student.

    Partial Year Membership - $65
    New and partial year full members, received after February 1, 2017.

Membership Type *
Membership Status*
How did you hear about us? (for New Members)
Name of a Friend
Dual Membership (specify the other club to which you belong)

CFUW K-W Charitable Fund Donation(s) (tax receipt will be issued).
Please specify $ amount.
Carolyn Haehnel/Mabel Dunham Fund (to achieve sustainability)
Edna Haviland Fund (to achieve sustainability)
CFUW K-W Charitable Fund – Unrestricted

Alternatives to the printed directory:

  • Online Directory – the latest up to date membership – which can be accessed through the Members Area of this website
  • Download a pdf version of the directory, then transfer it to your cell phone or tablet OR email our Web Administrator 
Paper copy of Membership Directory?*
   
Year you joined CFUW KW*


I certify that all the information provided in this registration form is accurate and true and that I support the principles of CFUW.

I understand I may attend interest group activities only when my membership dues for the 2016-17 membership year are paid in full.

Payment Options*
   

PayPal instructions: 

Detailed instructions can be found here

Cheque instructions:

Make cheques payable to: CFUW Kitchener-Waterloo 
Mail to:

Jo-Ann Carlisle
70 Ellis Ave
Kitchener, ON N2H 4G7

Please indicate if you have an interest and/or experience in any of the following areas of club need:
     
     
     
     
     
Other skills

Book Sale

The 53rd Annual Used Book Sale will take place on Friday, April 21 and Saturday, April 22, 2017 at First United Church, corner of King and William Streets in Waterloo. The Book Sale is our Club’s ONLY fundraiser and requires about 800 hours of woman power to cover the various shifts. 

Sorting shifts will take place from 9:00 a.m. to 9:30 p.m. on Wednesday, April 19 and Thursday, April 20, 2017.

Please note that the Shift Signup is not included on this form; it will be sent electronically by the first part of December (mail out to those without e-mail).  The intent is to simplify the co-ordination of shift coverage. Also, members will hopefully be more aware of their travel plans and availability in December.

Thank you, in advance, for volunteering at our upcoming Annual Book Sale.


Collection of Information

The information collected on this form will be used by CFUW Kitchener-Waterloo to create a database of members.This database will be used to publish a membership directory for the personal use of members, be analyzed for membership trends. It will not be sold, loaned, or provided in any way to any other individual or organization. Under the Freedom of Information and Protection of Privacy act (FOIPP) permission is needed to print/post images or information on our CFUW members in our monthly newsletter and on restricted Member Area of this website. Remember that the Directory is available in print and on restricted Member Area of our website and is only available to current members. It is not to be used for marketing purposes. 

 If you have any objections to your name or picture (including your personal information) being included on the RESTRICTED MEMBERS AREA of our website (it is password protected so general public CANNOT ACCESS THAT INFORMATION), please check "Yes".

Objections to being included in our website? *
   
If you have any objections to your name or picture (including your personal information) being included in our PRINTED DIRECTORY, please check "Yes"
Objections to being included in printed directory? *
   

Please upload a high resolution photo (e.g. directly from your digital camera or cell phone) of you for our Membership Directory. 

Picture upload
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