To help us build a better future for you and your children,

To help us build a better future for you and your children, we need your continued support.

Please complete and return this form with your contribution or donation today. Please do not mail cash.

Please print out this form, fill it out with your Signature & mail it to

The BC Social Credit Party, c/o 1182 Nootka St Vancouver B.C. V5K 4E7

------------------------------Please print in block letters----------------------------

BC Social Credit Party - Membership application/donation/volunteer form

Mr__ Mrs__ Miss__ Ms__ Other__ New__ Renwal__ Yes! I want to help__

First name_________________Initial___ Phone__________________________

Last name________________________ Fax____________________________

Address_________________________ E-mail__________________________

City__________________Prov_______ Signature_______________

Postal Code___________

Membership fees sent with this form $________ Donations sent $________________

Memebership Fees (maximum 5 years) Reg. $10.00 per year, Senior $5.00 (65 or over)per year,

Young Socred (16-28) $5.00 per year.

Please make cheques payable to 'BC Social Credit Party'.

Membership dues must accompany your application form.

A receipt for income tax purposes will be issued for all contributions in excess of $10.00

OFFICE USE: Received by ________________ Date________ Constituency ______

Processed by____________________Region#______Contact#_________________

Important Notice:

Membership in the BC Social Credit Party is subject to 30 days waiting period.

Membership in any other provincial parties will automatically void membership in the BC Social Credit Party.

Mail to: BC Social Credit Party, c/o 1182 Nootka St Vancouver BC V5K 4E7

'Authorized by BC Social Credit Party Financial Agent, Carrol Woolsey.'