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CBA membership signup
Complete this form, along with a payment method (cheque or e-transfer) to become a CBA member and experience the benefits of membership!
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* Required
Last Name
*
Your answer
First Name
*
Your answer
Additional names at the same address (Last, First)
Your answer
Email address
*
Your answer
Address
*
Your answer
Postal Code
*
Your answer
Phone number
Your answer
Membership type
*
New member
Renewing member
Advertising member
Signup period
*
1 years ($10)
2 years ($20)
3 years ($30)
5 years ($50)
Advertising ($20/year)
Payment via (for details see
http://www.cbasn.com/membership/
)
*
E-transfer (to
cbamail@cbasn.com
, use password "membership")
Cheque (Mail to PO Box 41003, 5166 Cordova Bay Road, Victoria V8Y 0A3. OR dropoff at IDA pharmacy)
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