Friends of Peche Island - Membership Application

Name:________________________________________

Address:______________________________________

_____________________________________________

_____________________________________________

Phone: (___)___________________________________

Email:_________________________________________

Date:__________________________________________

Please Select Membership (Canadian Funds):

___  $35 SINGLE - Includes FPI T-Shirt, FPI Decal and one round trip Water Taxi Pass

___  $65 FAMILY - Includes 2 FPI T-Shirts, FPI Decal and up to 4 round trip Water taxi Passes

___  $100 SPONSOR - Includes single membership and a $70.00 tax receipt plus one full season Water Taxi Pass, FPI Decal and an FPI T-Shirt

___  $200 FAMILY SPONSOR - Includes family membership and a $140.00 tax receipt plus up to 4 full season Water Taxi Passes, FPI Decal and 2 FPI T-Shirts

___  $500+ PATRON - Lifetime membership and a $350.00+ (@ 70%) tax receipt, 2 FPI T-Shirts, FPI Decal and a lifetime Water Taxi Pass

Donation Amount (Do NOT Send Cash in the mail):

___  $35        ___  $65        ____  $100        ___  $200        $__________

T-Shirt Size/Quantity:

S ____    M ____    L ____    XL ____   XXL ____

Method of Payment:

___  CHEQUE        ___ VISA        ___  MASTERCARD        ___  AMERICAN EXPRESS

Card #:______-______-______-______   Expiry Date: (YY/MM)  _____/_____

Please Print, Complete and mail to:

Friends of Peche Island

203-119 Chatham Street West

Windsor, ON N9A 5M7