Regina CAHSmembership

Canadian Aviation Historical Society

Roland Groome Chapter, Regina, Sask.

Membership Application 2013

New

Renewal

Data Unchanged

Chapter Membership Types and Rates

WINDSOCK BY EMAIL $15 Canadian & International Addresses

WINDSOCK - PAPER COPY BY MAIL $20 Canadian; $30 International Addresses

Please Make Cheques Payable to: "Roland Groome Chapter - CAHS"

Membership Application 2013

Name:

Address

City

Province

Postal Code

Phone

e-mail address

Mail to: Canadian Aviation Historical Society,

Roland Groome Chapter, Regina, Sask.

c/o Zoltan Bodas

158 Rodenbush Dr.

Regina, Sask.

S4R 7Y1

zbodas@sasktel.net

PRIVACY STATEMENT: The Canadian Aviation Historical Society (CAHS) is required under the Personal Information Protection and

Electronic Documents Act (2000, c.5) to advise members that this form is collecting personal information. Members must supply their

name and postal address as these are required by the Society to carry out its routine business matters. Name and contact details may

also be published in a Members Directory distributed to all members for non-commercial purposes. Check the following box only if

you DO NOT wish to have your telephone numbers or e-mail address included in the Members Directory.