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CFUW Nepean 2023-2024 MEMBERSHIP FORM
CFUW Nepean is a member club of the Canadian Federation of University Women, a national affiliate of Graduate Women International.
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FIRST NAME
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Your answer
LAST NAME
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Your answer
RENEWAL
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YES
NO
ADDRESS (Number and Street)
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Your answer
Apt#
Your answer
CITY
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Your answer
Postal Code
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Your answer
PREFERRED TELEPHONE NUMBER - what is the best number to reach you?
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Your answer
Email
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Your answer
EDUCATION (Degrees/Diplomas, etc.)
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Your answer
PAST OR CURRENT EMPLOYMENT EXPERIENCE
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Your answer
SKILLS AND INTERESTS
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Your answer
NEW MEMBERS- How did you hear about us?
Your answer
INTEREST GROUPS (Check those which you would like to join in 2023-2024)
Armchair Travel (3rd Tues 1 pm)
Art Tours (2nd Wed 1 pm)
Book Club (4th Tues 1 pm)
Bridge (Mondays 1 pm)
Lunching out (3rd Wed noon)
Movie Matinee (2nd Fri aft)
Environmental Action (3rd Thurs 1 pm on Zoom)
Friday/Exercises/Chat (Fridays 10 am)
Advocacy
Community Outreach
Suggestion for a new interest group
Your answer
If you have suggested a new interest group, will you organize it?
Yes
No
Clear selection
MEMBERSHIP FEE - Please make cheque payable to CFUW Nepean and mail to Dolores Dufresne, 119 Dalecroft Cres., Nepean ON K2G 5V8, or e-transfer funds to
CFUWNepean91@gmail.com
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Full Member: $110
Dual Member: $40
Do you plan to pay your dues by:
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e-transfer to
CFUWNepean91@gmail.com
mail (cheque)
in person (cheque or cash)
If Dual Member, enter name of other Club
Your answer
CFUW Nepean may publish photos of Club members engaging in Club activities. Do you agree to have your photo published?
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Yes
No
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