Please complete the application form, print and mail it along with payment to the address below.

All applications are reviewed by the Executive Board once a month.
Membership Fee: $65 annually (not pro-rated). Membership Term: June 1, 2009 to May 31, 2010

Please indicate type of membership:
New Membership Renewal Life Membership

Name
Designations
Title
Company
Address
City
Province	No Selection Alberta British Columbia Manitoba New Brunswick Newfoundland Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan
Postal Code
Phone	- - EXT
Fax	- -
E-mail Address
How would you like to receive your monthly bulletin?	E-mail Regular mail
What do you do in your job?
Do you have a subject/speaker suggestion for the monthly dinner meetings?

Please indicate which committees you would like to join:

Bulletin	Industry Events	Membership
Cowan Group Award	Insurance Information Campaign	Publicity
Education	St. Paul Fire & Marine	Wine & Cheese
Golf Tournament	Meeting Coordinator	FUN
Convention 2009	Web Master	Form a New Committee

Please print this application and send along with your cheque made out for $65 cheque payable to
Toronto Insurance Women's Association and mail to:

TIWA
31 Adelaide Street East, P.O. Box 861
Toronto, ON M5C 2K1

If you wish to pay your Membership via PayPal, click the BUY NOW button.

You must still complete and mail or email your application to TIWA.