MEMBERSHIP APPLICATION To join as a member of the Planning & Design Centre, please return this form via mail to 5257 Morris Street, Halifax, NS, B3J 1B6. You can also join by calling 902.494.8494 Name __________________________________________________________ Address _________________________________________________________ Home Phone ________________________ Work Phone __________________ E-mail __________________________________________________________ I would like to join the Planning and Design Centre for 3 years at the following level: INDIVIDUAL
$500 - $999
$50 - $499
I would like to include an additional gift of $_______________________
I would like to pay with cash.
My check payable to the Halifax Community Planning & Design Association for $______________ is enclosed.
Signature _________________________________ Date ____________ Thank you for your support!