Membership Application / Renewal & Change of Address

Please print form, complete and mail with your cheque to
EHANS, P.O. Box 31323, Halifax, NS B3K 5Y5.
Make cheque payable to: EHANS





Postal Code____________________

Email Address_______________________________________

(opt) Phone (Home)___________________

(opt) Fax____________________

______ New Membership ________ Membership Renewal

___ $75 Supporting Membership
___ $25 Individual Membership
___ $35 Family Membership
___ $5 or more Pay What You Can Membership (Canada)

Donation _______________
Tax receipts are issued for all amounts $10 and over

Is there some way in which you would like to help the EHANS as a volunteer?