Icelandic Canadian Club of Edmonton

Nordurljos Chapter 
of the Icelandic National League of North America

 

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Membership Confirmation Page


Thank you for sending your membership form. We will use the following information to contact you:

Name: Name
Address: Address
City: City
Province/State: Province
Postal/Zip Code: Code
CountryCountry OtherCountry
Phone: Phone
Fax: Fax
E-mail: Email

My contact information in the directory 
YES, publish   NO, DO NOT publish

Your membership category is: Membership
You have made a donation fordonation

Your total due is: Total

If any information is incorrect, please change it on the form by clicking the back icon on your browser.
Please remember to mail your payment to:

Charles Grant

4203 – 120th Street

Edmonton, AB T6J 1X9

Ph. (780) 434-4469

Email: chgrant@shaw.ca

Thanks for joining the Icelandic Canadian Club of Edmonton!

 

Revised: June 21, 2006 .