Ikebana International Membership Form - 2014-2015

New membership is available at anytime.  Annual renewal date is May, for the following year.  

Make your cheque for $120.00 payable to: I.I. Ottawa Centennial Chapter No. 120 and send it to the current Membership Chairperson, c/o P.O. Box 9562, Station “T”, Ottawa, Ontario, K1G 3Y2.

 

 

 

Ottawa Centennial Chapter No. 120 of Ikebana International - Membership Form
Please print clearly.

 

                                                                                                                                          (Optional - circle one)
Surname: _______________________________   First Name: _____________________   Mr.  Mrs.  Miss. Ms.

 

Address: _____________________________________________ City: ____________________ Prov.: ______

                                                                                                          (New)
Postal Code: ________________    Birthday (Day/Month)_____________   Spouse’s Initials:____________

 

Telephone 1: ____________________   Telephone 2: ___________________    Fax: ____________________

 

E-mail: ______________________  Membership No. ______________   Ikebana school: _________________