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 Membership Form

Adult Day Centres Association Home

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How to use this form: To become a member using this form, you need to fill  in the information and click the send button below. Then you will need to send in your payment by mailing us a cheque for the amount you indicated. We hope to have the ability to accept online donations soon. All donations are tax deductible and receipts will be issued from our office.

Please remember that the Society's ability to enrich the programs comes in part from your donations, so please be generous.

By sending this form, you consent to the use of your contact information for the delivery of the White Rock/Surrey Come Share Society Newsletters and notifications of special events.

Please send your membership payment and/or donation to:

The White Rock/Surrey Come Share Society
15008 - 26th Avenue
Surrey, BC V4P 3H5

Thank your for sending us this form.

Email Address
Name *
Address
*
Telephone
PostalCode *
Membership: Yes   No
I'd like to become a member of the society
Board: Yes   No
I'm interested in standing for election to the board
Committees: Yes   No
I'd like to sit on a standing committee
Would you like to make a donation?: $10.00
$20.00
$50.00
$100.00

Amount of your choice
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