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POMBA Halifax Membership Form 2020-2021
All Memberships are Valid from July 1st 2020 to June 30th 2021
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Membership Level
*
Choose
Family
Single Parent
Out of Town (100kms or more outside Halifax)
Alumni (Multiples are over the age of 10)
First AND Last Name
*
Your answer
Spouse/Partner's First AND Last Name
Your answer
Street Address
*
Your answer
City
*
Your answer
Province
*
Your answer
Postal Code
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Email Consent - I consent for POMBA Halifax to email me newsletters, event RSVPs, membership reminders, notices and bulletins.
*
Yes
No
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