Registration Form for the Ottawa Smockers' Guild

Name: __________________________________________
                                          (please print clearly)

Apt./Unit: ___________________________
Street: ______________________________
City: _______________________________
Postal Code: ____________________
Home Telephone Number: ____________________________
E-Mail Address: ____________________________________

Please include your cheque for $15.00 made payable to
     “The Ottawa Smockers' Guild”
Mail your completed form to:
 Guild Membership,
 1481 Chomley Cresc.,
 Ottawa ON K1G 0V9