Print this page and mail the completed form below to:
Cottonwood Mansion
P.O. Box 56, Selkirk, Ontario, Canada N0A 1P0
| Name: | for | Calendar Year 2007 |
| Address: | ___ | Annual Member $25 |
| Address: | ___ | Donor Member $100 |
| Postal Code: | ___ | Life Member $250 |
| Telephone: | ___ | Other $______ |
Please make cheque payable to Cottonwood Mansion
For information call: (905) 776-2538
E-Mail: cottonwoodmansion@linetap.com