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    Name:

    Address:

    City/Province:

    Postal Code:

    Telephone Number (Home)

    Telephone Number (Work)

    Email:

    Organisation/Position (if applicable):

    Membership Option:

    Individual membership, Regular: 1 year - $20.00Individual membership, Regular: 2 years - $35.00Individual membership, Student/Senior/Unwaged: 1 year - $10Individual membership, Student/Senior/Unwaged: 2 year - $15Institutional membership: 1 year - $100.00Institutional membership: 2 year - $180.00

    Would you like to keep up-to-date with our events and exhibitions by subscribing to our mailing list?

    YesNo


    If you attend a WHM event do you grant the WHM permission to use your likeness in a photograph or video in any and all publications and materials?

    YesNo

    How did you hear about us? (this one doesn't have to be answered)

    OnlineWHM eventOther

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