Membership Application Form 1. Contact Information Name (required) Street Address City Province OntarioAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutPrince Edward IslandQuebecSaskatchewanYukon Postal Code Phone Number (required) Email Address (required) If an organization, please provide contact information for a representative 2. Membership Membership is for one calendar year. Membership card will be issued after Board approval – please complete below I am currently a member and wish to renew for the upcoming yearI would like to become a member for the upcoming year * * If you are an OPP employee, uniform or civilian, a sponsor is not required. A sponsor is required for all non-OPP employees. Below is the name of a person who is currently a 'Friends' member who will sponsor me: Friends of The OPP Museum is a non-profit charitable organization that supports and promotes The OPP Museum. It reserves the right to withhold membership from any person if it determines that the person has or is likely to act in a manner that may be detrimental to the affairs, image or reputation of the Friends or of the Ontario Provincial Police. Membership Fee*: $25.00 I would also like to make a donation**: TOTAL: * No tax receipt issued for membership fee. ** Tax receipt issued for donation. Registered Charitable Organization # 81381 0819 RR001 3. Privacy Waiver Friends of The OPP Museum may publish, post or otherwise disclose my name as a member and/or supporter in its publications and/or website along with the name of any person I associate with my donation. (Please be aware that in giving your permission you are also doing so for any other person you name in association with your donation.) I agreeI do not agree 4. Additional Donation Information I would like to make this donation in honour ofin memory of A note acknowledging this donation should be sent to: 5. Payment Information Payment will be made onlineOther (e.g. cash in person or cheque sent by mail) 6. Communication Preference Please send Friends of The OPP Museum correspondence, notices, publications, etc.: By regular mail to the address above By email to the email address above By OPP internal mail to (Detachment/Bureau): Please DO NOT send any communication The information provided is collected by Friends of The OPP Museum in order to deliver its mandate as a registered charitable corporation to support and promote The OPP Museum and the history of the OPP. Except as may be required by law, it will not be disclosed without expressed written permission, and will be retained in accordance with our policy. Friends does not sell or otherwise provide member or supporter personal information to any other organization. Make a payment