A-IAC 2023 YOUTH MEMBERSHIP FORM                 One Form For Each Member (40 & under)
A-IAC YOUTH MEMBERSHIP FORM (40 and under) Please completed ONE Form For Each Member
ALL INFORMATION IS PRIVY TO THE BOARD MEMBERS ONLY
Please complete all sections of this form.  

21 years and under: FREE
Over 21 years: $25 per person

TO PAY BY CHEQUE write it out to: 
'The Anglo-Indian Association of Canada' (no abbreviations please) 

MAIL YOUR CHEQUE to the address below:
The Anglo-Indian Association of Canada
6471 Longspur Road, 
Mississauga, ON
L5N 6E4

TO PAY BY E-TRANSFER: aiac02009@gmail.com and list the full names of the members being paid for  in the message section of the E-Transfer.

You should receive an automatic email acknowledgement once you complete this form. (Please check your spam mail too.)
 If you have paid your fee already, we THANK YOU!!
Sign in to Google to save your progress. Learn more
Email *
FIRST NAME *
LAST NAME *
DATE OF BIRTH (date-month-year) *
PHONE  xxx-xxx-xxxx *
HOUSE/APT NUMBER *
STREET NAME *
CITY *
PROVINCE *
POSTAL CODE *
CHECK YOUR PREFERRED MODE OF PAYMENT(over 25) *
$ AMOUNT PAID
I hereby grant permission to use photographs/videos of me taken at the Association’s Events and on Social Media. *
Required
The Association and the Board shall not be responsible for any loss or injury I might sustain at any of the events. *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms