Membership Form

Membership Application

    2023-24 Season

Please complete, detach and mail with a cheque for the amount appropriate for the category of membership you wish to:

The C. G. Jung Society of Montreal

Box 22515

Montreal QC H4A 3T4

__________________________________________________________________________________________________________

Membership Category

Regular $40                                     ___   

Student ____ or Senior $25              ___ 

Newsletter subscription only, $25      ___ 

Sustaining Member  $100  ___ or      ___

Send the Newsletter, etc. by Email   ___

Send the Newsletter, etc. by Post     ___

__________________________________________________________________________________________________________

Please print in block letters

Name ___________________________

Street ___________________ Apt. ___              

City _____________________    

Prov.  ____  Postal Code  ____________

Email ____________________________ 

Phone ___________________

Fax ______________________