Stroll of Poets Society Membership and Registration Form

www.strollofpoets.com

Membership and Stroll Registration

Print this form and send it and a cheque to:
Stroll of Poets Society
c/o Writers Guild of Alberta
Percy Page Centre
11759 Groat Road
Edmonton, AB T5M 3K6

Name:

Address:

Postal Code:

Phone home

Phone work

E-mail

First Time Member?

yes no

I wish to perform in the
Stroll weekly series (Deadline TBA)

yes no
I understand that I will be contacted later regarding dates.

I wish to volunteer to work on

Stroll Anthology
Weekly series

Please include my name, number and email address in the directory distributed to Stroll members.

yes no

Annual membership fee:

$20 (valid until the 2010 AGM in late March)

Donation (thank you):

$____

Total:

$____