The Leduc and District Historical Society Membership Application

Name

Email Address

Phone

Best Time to Contact

Street

City

Province

Postal Code

What days of the week are you
available?

Time Available (Check all that apply)

Morning

Afternoon

Evening

Weekends Weekends

Are you 18 years of age or older?

Yes

No

Have you previously been a member
of the Leduc and District Historical Society?

Yes

No

Where did you hear about us?

What size shirt/apron do you wear?

Would you like your name embroidered on your shirt/apron?

Yes	No
I'll embroider my own	I prefer having a blank apron, no embroidery

Comments/Additional Information