MEMBERSHIP APPLICATION / RENEWAL

Membership is $25.00 per person per year from January 1st to December 31st of each calendar year. Members must be 18 years or older, Canadian citizen or landed immigrant, Hellenic heritage by marriage or ancestry.

Membership Renewal (for the year ) New Membership Application

Name:

Address:

City:

Province:

Postal Code:

Phone Number:

Fax Number:

Email:

Method of Payment:

Visa

Card Number:

Expiry Date (Month/Year):

Cardholder name:

To mail or fax this form, send to:
Penny Stathopoulos, Executive Assistant & Housing Manager
33 Winona Drive, Toronto, Ontario, M6G 3Z7
D. (416) 654-3987
T. (416) 654-7700 ext. 2223
F. (416) 654-0943
Email: pstathopoulos@hellenichome.org