CPA 2009 MEMBERSHIP APPLICATION






    Membership is open to anyone with an interest in poetry, with affordable low annual dues.
    Membership is also open to literary organizations. The CPA Membership is based upon
    the calendar year (January 1st to December 31st). Membership includes a subscription to
    Poemata newsletter. Cheques should be made payable to the CPA (Canadian Poetry
    Association). A charge of $20.00 will be levied against NSF cheques.
    *CPA PayPal is managed by River Bones Press.


    Name:__________________________________
    _______________________________________
    Address: ________________________________
    _______________________________________
    City/Town: ______________________________
    Postal Code: _____________________________
    Phone:__________________________________
    E-mail: _________________________________

    (   ) Please include me in your email update submission list

    Membership Details

    (   ) $30.00 Regular Membership
    (   ) $25.00 Student/Senior/Fixed income
    (   ) $45.00 International Membership
    (   ) $50.00 Association Membership Poetry
    (   ) $150.00 Library/bookstores affiliate
    (   ) New Membership  
    (   ) Friends of the CPA $50 and up
    (   ) Renewal


    •        All Cheques or Money Orders payable to:

    Canadian Poetry Association
    331 Elmwood Dr. Suite 4-212
    Moncton, NB, Canada E1A -1X6

    *note - no refund of membership.
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