Receipt requested YES _ TPS No R134722958 TVQ No by baq95300

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									PLEASE COMPLETE AND RETURN ALONG WITH YOUR PAYMENT TO: ALAI Canada                        c/o Gisèle Chabot
P.O. Box 61534, Station Tétreault-Ville, Montreal, Quebec, H1L 6R1       Web: www.alai.ca
We wish to renew our membership to ALAI Canada for 2009 in the category mentioned below: :
We enclose our payment for 2009 in the amount of : $__________, including applicable taxes
Receipt requested :        YES _______
TPS No: R134722958      TVQ No: 1015316493

INDIVIDUAL MEMBER
Name                                      Signature                                 Annual Fee       Admission fee       Total
                                                                                    125 $            25,00 $             141,09 $
_______________________________           ________________________________          + taxes          + taxes=28,22 $     or
Address :                                 Phone. :            fax. :                141,09 $         (new member         169,31$ (new
                                          E-mail :                                                   only)               member)
CORPORATE MEMBER
Company or Firm: _______________________________________________________________________________________________
Address :                                                                                        fax :


Name of delegate(s)                       Signature                                 Annual Fee       Admission fee     Total
                                                                                    160 $            Same as above     180,60 $
1. ____________________________           ________________________________          with taxes       -New member       or 208,82 $
Phone :                                   E-mail                                    180,60 $         only              (new member)
                                                                                    120 $                              316,05 $
2. ____________________________           ________________________________          with taxes
Phone :                                   E-mail                                    135,45 $
                                                                                    100 $                              428,93 $
3. ____________________________           ________________________________          with taxes
Phone :                                   E-mail                                    112,88 $
                                                                                    100 $                              541,80 $
4. ____________________________           ________________________________          with taxes
Phone :                                   E-mail                                    112,88 $
                                                                                    100 $                              654,68 $
5. ____________________________           ________________________________          with taxes
Phone :                                   E-mail                                    112,88 $
STUDENT               address :
Tel. :                                    Fax or E-mail :                           60$

								
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