pb on-line application

		Ukrainian Canadian Professional & Business Association of Hamilton MEMBERSHIP APPLICATION

Name
Preferred mailing address?					Business / School Address
Home	Business / School				Position / Title
Home Address					Company
Street					Street
City					City
Province					Province
Postal Code					Postal Code
Phone					Phone
E-mail Address					E-mail Address

How did you hear about us?
What are your interests?
Questions & Comments?
Type of Membership
Regular			Spousal	Graduate		Student
Membership $50			Membership $75	Membership $25		Membership Free
Note: To be applicable for a Graduate membership, you must have successfully completed a full-time post-secondary program within 1 year from the date of application and be a USC member. Upon membership renewal, Regular or Spousal fees will apply. Student memberships are only available to USC members enrolled in a full-time post-secondary program.
To submit your application now, click here
Please make cheque payable to the UCPBA of Hamilton. Send cheque (and application if not submitting electronically) to: Membership Chair, UCPBA, 1252 Barton St E, Hamilton, ON, L8H 2V9