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 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 (65 or over) $5.00 per year, 
Young Socred (16-28) $5.00 per year. 
Please make cheques payable to  'BC Social Credit Party'.
Membership dues must accompany with your application form.



Signature_______________________________ 
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 B.C. V5K 4E7 
Membership dues must accompany your application form.

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