Application for Branch Membership

Please use the Tab Key to move from field to field. All fields on this form are required, please make sure to fill in all the fields and click the submit button once.
After submitting the form, please send your cheque to:
Toronto Branch - UELAC, 40 Scollard Street - Suite 300, Toronto ON M5R 3S1.

Individual Membership $60.00

Family Membership $85.00 (those under 18 living in same home)

All prices are in Canadian Dollars and include GST.
U.S. orders please pay in American Dollars.

First Name»
Last Name»
Postal Code»

Place of Birth & Date»
Spouse - Name in Full»
Loyalist Ancestor(s)»
Military Service (Rank and Regiment if known)»
Where Settled and Date»

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