Membership Application/Renewal Oct 2022–Sept 2023 
Membership is valid until the September 2023 Annual General Meeting. Thank you!

You can fill out this form without signing into your email. If you have any issues with this form please call 604-669-5051 and ask for Evelyn.
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First Name *
Last Name *
Address *
Suite number - street number and name, city, postal code, and buzzer
Home Phone Number *
xxx-xxx-xxxx format
Cell Phone Number
xxx-xxx-xxxx format
Email Address *
Date of Birth *
MM
/
DD
/
YYYY
What are your pronouns?
Example he/she/them
We welcome you to let us know how you identify
For example gender, sexual orientation, or ethnicity
Emergency contact's first and last name?
Emergency contact's phone number
Emergency contact's relationship to you
How did you hear about WESN? *
Required
Consent and Activity Waiver

By purchasing a WESN membership you consent to WESN taking photos of you for print, online, video with/without your name, for any lawful purpose. Second, you release and forever discharge all legal rights and claims for injury/damages you may sustain participating in WESN activities with volunteers or staff. You discharge WESN employees from all injury/damages sustained by you arising from said participation. Finally, you WESN will not disclose your information without my consent, unless requested under the Societies Act, and will not rent, sell or trade their contact list.

Charitable Registration #119292845RR0001
Would you like WESN to mail you our monthly newsletter? If so please add an additional $25 to your payment
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Would you like to make a donation to WESN to help us deliver our programs and services? If so how much would you like to include in your payment.
How are you paying for your membership? *
Payment Options
Please send your $10 membership fee along with any any other donations or monthly mailed newsletter subscription to:
  • To pay by debit or cash please come in person to Barclay Manor
  • To pay via credit please go back to the Membership page on our website and click on the "Pay for my membership" button after submitting your application.
  • To pay by E-transfer send to info@wesn.ca
  • To pay by cheque either mail or drop off a cheque made out to WESN at Barclay Manor, 1447 Barclay St. Vancouver, BC V6G 1J6
  • To pay by cash either mail or drop off cash to WESN, Barclay Manor, 1447 Barclay St. Vancouver, BC V6G 1J6
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