Membership application

Name:
Address:
Business or Society Name (if applicable):
Official Representative (if Business or Society):

Phone Number: e-mail:

Help out at Foundation events
Help with administrative tasks, e.g. stuffing envelopes
Serve on a committee (circle one): Events, Public Relations, Finance, Legacy, Investment
Other (please specify):

Membership to the Kootenay Lake Hospital Foundation Includes:

Membership to the Kootenay Lake Hospital Foundation,
The right to attend Annual General Meetings and vote on the following: any changes to the Constitution and Bylaws, Election of New Directors, Audited Financial Statements.
The right to attend general meetings as they are called by the Board of Directors.
One newsletter per year, to be posted on a future website, emailed, or mailed to the member.

For my $20 membership fee, if accepted as a member of the Kootenay Lake Hospital Foundation, I agree to abide by the governing bylaws, policies and procedures of the Foundation.

Signature of Applicant

Date:

Approved/Rejected

Board Chair, KLH Foundation

Date:

FOR OFFICE USE ONLY
Payment Received
Yes/No