Youth Membership application
Youth Leadership Society of British Columbia
3096 Robson Drive, Coquitlam, B.C., Canada
Tel/Fax: 604 941 1317
Name *
Your answer
Date of Birth *
Your answer
Email *
Your answer
Name of Parent(s)/Guardian *
Your answer
Parents' / Guardian's email address *
Your answer
Home address *
Your answer
Home phone number *
Your answer
Your Cell phone number *
Your answer
Tell us more about yourself (eg. grade, school, hobbies and interests). *
Your answer
What program(s) offered by YLSBC are you interested to join? Each program has its own registration process and fee as announced from time to time. *
YLSBC programs requires a certain commitment to volunteer your time. Are you willing to volunteer your time to YLSBC? *
If yes, please advise your preferred areas for volunteering with YLSBC. *
Your answer
YLSBC program (s) require parent participation from time to time as needed and and mutually agreed upon. Are your parents willing to volunteer with YLSBC? If yes, please ask them to register as well through our web site. *
Please provide three references with phone numbers *
Your answer
I accept YLSBC's Code of Conduct as posted on the YLSBC's web site. *
Copy of By-Laws are available at request. Are you requesting a copy to be emailed?
I agree to receiving emails from YLSBC about its announcements from time to time. *
I give consent that my name, other information, and/or photographs through participation in YLSBC programs be used for the promotion or future publications of the YLSBC's programs *
YLSBC's annual membership fee is $20. Each Programs fee will be announced at the time of registration. *
I will pay the membership fee as follows; *
I have completed the payment process *
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