If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required GVJCCA Membership Form Last Name * First Name * Spouse's First Name Address * City * Province * Postal Code * Phone Email * RenewalNew MemberChange of Address Membership Type (yearly) * Regular Membership Only (No Bulletin) $20Regular Membership & Subscription $40 (Bulletin delivered)Regular Canadian, US, or International Membership & E-Subscription (Bulletin PDF Only – no delivery) $25Seniors (65+)/Students Membership & Subscription $30 (Bulletin delivered – in Canada only)Students Membership & E-Subscription $20 (Bulletin PDF only – no delivery)US Membership & Subscription $80.00 ($65.00 USD)International Membership & Subscription $135.00 (CAD) Please activate my membership for: * 1 Year2 Years3 Years4 Years5 Years I would like to support the GVJCCA and The Bulletin by donating the amount below: All donations will be acknowledged in the following issue of The Bulletin Total amount submitted We are working on web-based payment options. In the meantime, please send a cheque for the total of your membership + donation amount (if applicable) to JCCA, 249 - 6688 Southoaks Crescent Burnaby, BC, V5E 4M7 Tel: 604.777.5222 Email: gvjcca@gmail.com Make cheques payable to: GVJCCA Once your cheque has been received your membership will be activated. I would like to make the following changes to my membership: Prove you are human! What is 2 + 2? *