BECOME AN ASSOCIATE MEMBER TODAY!

To pay by credit card, simply fill out the information categories below and click the PROCEED button.

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CONTACT INFORMATION
Name:*
Farm / Business Name:
Address:*
City/Town:*
Province:*
Postal Code:*
Phone:
Email:*
Land Location:
RM / County:

MEMBERSHIP AND DONATION INFORMATION
I would like to:
BECOME AN ASSOCIATE MEMBER ($150.00 + GST/HST)
Please select your province of membership:
	Alberta British Columbia Manitoba New Brunswick Nfld and Labrador Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan
MAKE A DONATION
	I also enclose a one-time contribution of: $ (please enter amount only without $ sign)
	I would like to make a donation to CAEPLA's National Energy Board Project of: $ (please enter amount only without $ sign)
	I would like to make a donation to The Saskatchewan Surface Rights Project of: $ (please enter amount only without $ sign)

If you prefer to pay by cheque, please makes cheques payable to CAEPLA. Mail your cheque to
CAEPLA, Administration Office, #257-918 Albert Street, Regina, SK S4R 2P7.

You will receive a receipt and introductory letter from CAEPLA and be added to our regular mailing list.