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   Membership Application        

   - Please print this page and fill it in or drop by the YCOA Office -

First Name:  
Last Name:  
Address:  
City:  
Postal Code:  
Phone  
email  
Membership Fee:     $ 10.00 per year
Membership Year:        April 1st  -  March 31st

 

______________________________________________
- Signature -


Please mail or drop off application with payment to

Yukon Council on Aging
4061 B - 4th Avenue
Whitehorse, Yukon Y1A 1H1

 

 
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