Membership Application

I would like to support the conservation of Winnipeg's built heritage with my yearly membership.

New Membership _________/Renewal__________

CATEGORIES (Please check one)
Indivual($20.00) _________
Organization/Family($30.00) ___________
Student/Senior ($15.00) ___________

CORPORATE MEMBERSHIP
Basic Corporate- ($100.00 & over) ___________
Sponsor Corporate- ($500.00 & over)____________
Sustaining Corporate- ($1000.00 & over)___________

Name: ____________________________________________

Phone: Home:______________________________________

Phone: Business:___________________________________

Fax:_______________________________________________

Address:___________________________________________

City & Province:____________________________________

Postal Code: _______________

I am interested in providing volunteer assistance in the following area(s):
Membership _____________ Finance ___________ Education ___________
Research ______________ Advocacy ___________ Other ____________

YOUR DONATION IS TAX DEDUCTABLE
I would like to make a contribution to support Heritage Winnipeg's Programs.
Enclosed is my tax deductable donation (Business No. 11895 6572 RR0001) of _____________
(We will forward a tax receipt to you for the amount enclosed).

Please make your cheque payable to Heritage Winnipeg;
#509-63 Albert Street, Winnipeg, Manitoba R3B 1G4