REGISTRATION FORM

 

   Name of Organization: ___________________________________________________________

 

     Contact Name and Address: ________________________                          Postal Code: _______

 

      Alternate Name and Address: ________________________                        Postal Code: _______

 

                                              Phone Number: ________                        Fax Number:___________

 

          E-Mail:_________________________________________________________________________

 

                                              ___ I am interested in volunteering on a Regina Sport Hall of Fame committee.

 

 

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MEMBERSHIP APPLICATION

 

___ Organization $50.00              ___Individual $20.00

 

My cheque for $_____ is enclosed.

(Cheque made payable to REGINA SPORTS HALL OF FAME INC.)

 

Mail cheque to Regina Sports Hall of Fame Inc.

P.O. Box 3763 Regina, Saskatchewan S4P 3N8