Membership Application Form Please complete the form below indicating the type of membership you require and your payment method preferences. Current membership dues are: Annual: $25, Life: $150 Approval of the board is required on all new applications Fields marked with an asterix (*) are required Full Name * Date Address * City * Province / State * Postal / Zip Code * Home Phone * Cell Phone Email * Membership Type * NewRenewal Payment Method * Cheque (by mail)Credit Card (by phone) Payment Amount * Please make cheques payable to: Swedish Canadian Rest Home Association