ANDY FUND OF KINGSTON MEMBERSHIP FORM

Annual membership is $20.00.  Please complete this form and send it with your cheque to “The Andy Fund of Kingston”, to the Membership Secretary Marj Peart, 43 Lakeland Point Drive, Kingston  K7M 4E8. 

Name: ____________________________________________________________

Address:______________________________________________________

_______________________________________

Postal code: __________________

Phone: _______________________ E-mail: _________________________

Annual membership fee:...............................................$ 20.00

Additional donation .................................................... $______

Total enclosed: ...........................................................$______

I would be interested in helping the Andy Fund from time to time. Please have someone contact me with information about the many ways in which volunteers enjoy getting involved.