Membership Application

Please accept my application / renewal for Membership in the Marquetry Society of Canada

Membership # (s)_______________

Mr. Mrs. Miss. Ms. ___________________________________________
First Last

Street: ___________________________________________Apt# ________________

City:______________________________Province/State:_______

Postal Code:____________________

Country:____________________

Telephone:________________________ E Mail: ________________________

Date:______________
Day - Month -Year

I am retired Yes No My occupation was / is _______________________________

The membership fee is $40.00

Your name will be added to the MSC membership list, which is only available to the current Executive members of the MSC.

Please make cheque payable to the "Marquetry Society Of Canada"
Mail this renewal or application and fee to Marquetry Society of Canada c/o Iain McIntosh, 36 Anglesey Blvd., Toronto, Ontraio M9A 3B5