Membership Form

Fill out the form below to submit your pledge.

Member Information
Billing Name:
Member Name:
Phone:
Address:
City:
Province/State:
Postal Code/Zip:
Country:
Email Address:
Favourite CIUT Show:
Are you A: Current University of Toronto student
Former University of Toronto student
Neither
New Donor to CIUT
Previous Donor to CIUT

Membership Level

(A tax receipt will be issued for all contributions of $25.00 or more.) Membership gifts are listed below.
Contribution Level One:
Friends of 89.5 newsletter
$25+
$30
$40
$50
$60
Contribution Level Two:
Choice of one gift
$75
$80
$90
Contribution Level Three:
Choice of two gifts
$100
$110
$120
$130
$140
Contribution Level Four:
All Three Gifts
$150
Above $150: (eg. 199.99)

Gifts
choose: No Gift Necessary
No Newsletter
T-shirt size S
T-shirt size M
T-shirt size L
T-shirt size XL
Ball Cap
Tote Bag