Application for Membership
in the Royal Canadian Institute for the Advancement of Science
The RCI is a registered charity. Memberships and donations are both fully eligible for charitable donation status for income tax purposes.
A Membership Desk is located in the Macleod Auditorium foyer at all Sunday lectures,
OR you may mail this form with payment to:
Royal Canadian Institute, 700 University Avenue H7-D, Toronto, ON M5G 1X6
Name (print) __________________________________________
Street_______________________________________________
Town/City___________________________
Postal code __________ Phone______________ Fax___________
E-Mail______________________________________
I would prefer to receive notices by mail only ______ by e-mail only______
Please exclude my name from mailing lists developed for other non-profit organizations_____
Please check category: Annual Membership Renewal____ RCI New Member_____
Regular $ 30___ Family $ 40___ Senior $ 20___ Student $ 20___
Sustaining $ 100___ (Five annual payments will make you an automatic life member)
Life Membership $ 500.00___ (one individual for life)
Annual Corporate Membership $ 500.00 ___
Donation:
general purposes___ scholarship__ other_____________________________________
$__________ TOTAL PAYMENT MEMBERSHIP AND DONATION
Cheque (payable to Royal Canadian Institute) ___ Visa ___MasterCard ___
Credit card: name of cardholder_______________________________________
Card # __ __ __ __ / __ __ __ __ / __ __ __ __ / __ __ __ __ Expiry ____/____
Signature _________________________________________________________
RCI membership year: October 1 - September 30. Members are invited to the Annual General Meeting in the Spring. Membership card, tax receipt for dues and donations, and Part II program brochure (winter program) are mailed in December.
Phone (416) 977-2983 Fax (416) 962-7314
E-mail royalcanadianinstitute@sympatico.ca
Web site: http://www.royalcanadianinstitute.org