Council For London Seniors - Printable Membership Form

Please fill it out, print it and return it with your cheque to the address below.

Council For London Seniors Membership Form

First Name:

Last Name:

Address:

City:

Postal Code:

Phone:

Email:

Choose your preferred membership type:

General Membership - ($20) Agency Membership - ($35)

Please make your cheque payable to the "Council for London Seniors" and mail it to:

The Council for London Seniors
78 Riverside Drive
London, Ontario
N6H 1B4

Thank you! We will be in touch with you soon!