Prince Rupert Community League, Edmonton Alberta

Please enter the following information to apply for a membership to the Prince Rupert Community League. We will contact you within 48 hours to arrange for pickup of the card and payment dropoff. Thank you!

If you prefer to register offline, please note that memberships can also be purchased at Servus Credit Union on Kingsway Ave.

Adult #1:

Adult #2:

Address

Postal Code

Home Phone

Business Phone

E-mail:

Child's Name	YY/MM/DD	Sex
		M F
		M F
		M F
		M F

Membership Type:

Senior Single Other Adult Family

Interested in Participating in Activities?

Yes No

Activity Interests

Willing to volunteer?

Yes No

Volunteer Interests

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