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, 2007 to May 31, 2008


Please indicate type of membership:
  New Membership    Renewal    Life Membership

 Name

 Designations

 Title

 Company

 Address

 City

 Province

 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

Print your application