YUKON HOME EDUCATION SOCIETY

2007/2008 MEMBERSHIP FORM

Name(s): ___________________________________________________

___________________________________________________

Mailing Address: ______________________________________________

______________________________________________

______________________________________________

______________________________________________

Phone: ______________ Email: ______________________________________ Fax: _____________

Children Year of birth

  1. _________________________________ M( ) F( ) ______________
  2. _________________________________ M( ) F( ) ______________
  3. _________________________________ M( ) F( ) ______________
  4. _________________________________ M( ) F( ) ______________
  5. _________________________________ M( ) F( ) ______________

( ) Please include my family’s names, address and phone number on a membership list available only to YHES members.

( ) Please do not include my name on a membership list, but I do wish to receive mailings.

 

Please complete this form and send with $20.00 annual membership fee (payable to YHES) to:

YHES

Box 31674

Whitehorse,Yukon

Y1A 6L3

For more information call: Jody Cox 660-5347