HARTA Membership

Name*

(Mr/Mrs/Ms/Miss/Sr/Dr) Surname First Name Initial Maiden Name

Address*

Street Address Address Line 2 City/Town Province Postal Code

Phone*

Phone

Email

Regular Member: First year of retirement is free. After that, the cost is $10.00 per year.

Years of Retirement

Are you also a member of one of ARTA's other branches?

Name of Branch (if known)

Other Members: $10.00 for one (1) year, payable by cheque or cash to the Treasurer. (Please don’t send cash in the mail.)

Please check one:

Signature*

Signature

Date

CAPTCHA