Regular Membership Registration (Eco-Steward, Non-Voting)

Please fill out the short form below to begin the membership registration process. A $5.00 membership fee can be sent (preferably) via AutoDeposit Interac E-Transfer to borealcentre@gmail.com, or via mail to PO Box 285,
6055B Centennial Rd West, Moberly Lake, BC, V0C 1X0.

Regular Membership Registration

Name *

First

Last

Email *

Phone (optional)

Address (optional)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Paid? *

• Yes
• No

Submit