Purchase Membership – Central Alberta 5 Pin Bowlers Association

Bowling Centre *

A5 Membership Number

If you are a new member of our group, or have forgotten your number, then leave this blank.

Request *

If this is a TRANSFER between two centres or provinces, please supply details

information about the transfer

Name *

First

Middle

Last

Show middle Initial if you have one.

Birthdate *

Day/Month/Year...January 15, 2010 would be...15/01/2010

Gender *

Street Address or Post Office Box *

City / Town *

Postal Code *

Primary Phone Number *

Secondary Phone Number (if available)

Email *

Membership Type *

Replacement means you want to get a replacement card as you have lost your previous card. Contact the Office for cost.

Cost *

ALL GOLDEN AGE & YOUTH MUST PROVIDE THEIR BIRTH YEAR TO RECEIVE THE DISCOUNTED FEE! Age at December 31 of the current year Adults are ages 22 - 54 Golden Age is 55+ Youth is under 19 years of age

Payment Method

E-transfers may be sent direct to the Alberta 5 Pin office at a5pba@telus.net

E-Transfer Date

Day/Month/Year...January 15, 2010 would be...15/01/2010

Cheque Number

If using a cheque, indicate the cheque number. When sending a cheque, please address it to Alberta 5 Pin Bowlers Association 432-14 St. So. Lethbridge, AB T1J 2X7

Use of Personal Information

Check one of the options below

Select one of the options *

Date *

Membership bonus offer

Name

When you have submitted your information, close this window to return to the previous page.