Individual Member

APPLICATION FOR MEMBERSHIP – GENERAL MEMBER

THE UNDERSIGNED makes application to the Corporation to become a General Member of the Corporation, and hereby represents and warrants the following to be true:

• I identify as Black or African Canadian;
• I am at least eighteen (18) years of age
• I am normally resident in the province of Ontario;
• I affirm my interest in furthering the Corporation’s purposes; and
• I have paid the annual membership dues, that being five dollars ($5), and I understand that such dues will be payable by me each year upon written notice of the board of directors of the Corporation.

Applicant’s contact information: