The Komoka Railway Museum Inc.
 
1. Please renew my membership at the Komoka Railway Museum.
 
   ___  -I have enclosed CDN$25.00 for a renewal.
 
2. Please register me as a new member for the Komoka Railway Museum.
 
   ___  -I have enclosed CDN$25.00 for an adult membership.
 
                       or
 
   ___  -I have enclosed CDN$15.00 for a student membership.  I am ___ years old.
 
 
Name:_________________________________________________________
 
Address:______________________________________________________
 
Province:_____________________________________________________
 
Postal Code:__________________________________________________
 
Phone: (____) ______-__________
 
 
I am also willing to help on the following committees (circle):
 
Archives       Artifact Display       Guide          Grounds        Fund Raising
 
Newsletter     Model Display          Social         Website        Rolling Stock
                                                                     Restoration
 
 
I would prefer to make a donation of CDN$________________   Tax receipt  YES  or  NO