Membership Forms

Individual Membership Form: 

*Indicates a required field.

Name *
Street *
City *
Province *
Postal Code *
Phone Number *
E-mail *
Preference for Eco-Journal (Paper or Electronic) *
 

Please send a cheque for $30 payable to Manitoba Eco-Network to:
Manitoba Eco-Network
3-303 Portage Ave.
Winnipeg, MB R3B 2B4

Or pay online at CanadaHelps.org. Just choose Individual Membership as the fund designation.

 

 

Group Membership Form:

*Indicates a required field.

Name of Organization *
Street *
City *
Province *
Postal Code *
Phone Number *
Fax Number
Contact E-mail (you may aosl include key staff/board member emails, separated by a comma) *
Contact Name *
Website
Briefly describe your environmental focus/mandate *
Number of Members
Preference for Eco-Journal (Paper or Electronic) *
 

Please send a cheque for $50 payable to Manitoba Eco-Network to:
Manitoba Eco-Network
3-303 Portage Ave.
Winnipeg, MB R3B 2B4

Or pay by credit card using PayPal

 

 

Associate Membership:

*Indicates a required field.

Name of Organisation *
Street *
City *
Province *
Postal Code *
Phone Number *
Email *
Contact Name *
Website
Preference for Eco-Journal (Paper or Electronic) *
Would you like your organization listed on our Members' page? *
 Yes
 No
 

Please send a cheque for $60 payable to Manitoba Eco-Network to:
Manitoba Eco-Network
3-303 Portage Ave.
Winnipeg, MB R3B 2B4

Or pay by credit card using PayPal