Online Membership Form

Member Information

Billing Name:
Member Name:
Phone:
Address:
City:
Province/State:
Postal Code/Zip:
Country:
Email Address:
Favourite CIUT Show:

Membership Level

(A tax receipt will be issued for all contributions of $25.00 or more.) Membership gifts are listed below.
Contribution Level One:
Membership + Prize Draw Entry
$25
$50
Enter your own donation amount totalling under $75 (eg. 60.01):
Contribution Level Two:
Membership + Prize Draw Entry + Campaign T-Shirt
$75
$100
$125
Enter your own donation amount totalling under $150 (140.01):
Contribution Level Three:
Membership + Prize Draw Entry + Special Edition T-Shirt
$150
$175
Enter your own donation amount totalling under $200 (eg. 180.01):
Contribution Level Four:
Membership + Prize Draw Entry + Campaign T-Shirt & Special Edition T-Shirt
$200
Enter your own donation amount totalling above $200 (eg. 500.01):

T-Shirt Size (for those who donate $75 +)

No Gift Necessary
Small
Medium
Large
Xtra Large
Press | Contact Us | Volunteer | Sponsorship/PSA Guidelines
2007 CIUT