Membership Registration

This form is to be used for anyone who is interested in becoming a member of the Canadian Ark Centre of Excellence.

If you have any questions, please don’t hesitate to contact us on ark@arkcentre.ca

Notes:

If you choose the “Direct Deposit” option, we will send you a form to be filled.
If you choose the “Paypal – Recurring Payments” option, complete this form & go to the “Donate” button (on the menu items) & select amount & Membership Fee option.
If you choose the “E-Transfer” option, complete this form & send funds to ark@arkcentre.ca .

Name *

First

Last

Gender *

Date of Birth *

Email *

Phone *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Have you ever attended Ark's programs before ? *

If you answered yes, how long have you been attending ?

How much you would like to contribute monthly ? *

If you chose other, please specify an amount

Payment Method *

Please share with us if you have any feedback or comments

Name