Formulaire d’adhésion – E – Association des Familles Messier

Membership Application

Please refer to the table on the right to select your status…

You can either complete the following form or click the link at the bottom of this page to access the form in Word format.

First and last name

Address, City, Postal Code (or Zip Code)

Phone number

I authorize Association des Familles Messier to publish my email address

Date and Place of birth

Date of birth

Married... Full name of your spouse, as well as the date and location of your marriage

Other... please specify your status

Your father: Full name, date and place of birth, and date and place of death (if applicable)

Your mother: Full name, date and place of birth, and date and place of death (if applicable)

Date and place of your parent's marriage

Your grandfather: Full name, date and place of birth, and date and place of death (if applicable)

Your grandmother: Full name, date and place of birth, and date and place of death (if applicable)

Date and place of your grandparent's marriage

Comments or questions?

the First is

In what format would you like to receive our newspaper?

Electronic
Paper

Do you wish to be...

Regular Member
Benefactor member
Lifetime Member

Please note that our newspaper "La Moisson des Messier" is included in your contribution and that your membership is confirmed when we receive your contribution.

I will send you a check today.
I'm sending you an Interac e-Transfer.

Printable Form in Word :

Click here