Membership Application Form

Please read the information on the right of this page before submitting your application.

Please enter your details and then click on the "Submit" button.

First Name:*
Surname:*
Street Address:*
Town/City:*
Province:*
Postal Code:*
(A9A 9A9)

E-mail Address:*
I want to opt out of receiving emails from Stephen Leacock Associates.
(if you select this, you will not receive our newsletters)

Telephone:* (999-999-9999)

Type of Membership:*    Single ($10)    Dual ($20)

SUPPLEMENTARY CHARITABLE DONATIONS are gratefully received.
$5    $10    $25    $50    $100   Other $

We will issue tax receipts for any amount over $10.

Please let us know how you can contribute to the aims of Stephen Leacock Associates. Our organization is managed and staffed by dedicated volunteers, and we need help from members to ensure that the Leacock Medal for Humour continues to be awarded for many years to come.

Please check off the areas where you would like to help:
Awards (administration of the awards process)
Finance (tracking and reporting on income and expenditure)
Event management (planning and managing our award ceremonies)
Fundraising (finding sponsors to fund our awards)
Public relations and communications (making us known)
Membership (increasing our membership)
Special Projects (evaluating and promoting strategic initiatives)

Help in other ways:
Fill in for, or become, the secretary
Update the web site
Manage the archives
Help with digitizing archives
Other:

Do you prefer to pay by: *    Credit or debit card     Cheque    


Challenge:*
Please enter the seventh, third
and second digits of the number
shown below, in that order.
2083440

* Essential information

Please check over your responses before clicking on the "Submit" button.



Membership in Stephen Leacock Associates offers a number of benefits:

Your membership subscription fee

is paid in Canadian dollars.  There have been cases where the box in which you enter your credit card details indicates that the payment is in US dollars.  This is a problem originating with Stripe, our payment processor. Don't worry, you will actually be charged in Canadian dollars!

Why we need your email address:

Your email address is an essential piece of information that will identify you on our membership records.  It is also needed to notify you when your membership is due to be renewed.  If you opt out of receiving emails, you will not receive our newsletters or any notifications about press releases or other items of interest.  However, you will still receive renewal notifications.

What is a "Dual" membership?

Because your email address is an essential piece of information for us, if you and your spouse or partner both share an email address, and both want to become members, you should choose the "Dual" membership option.  If you have different email addresses and want to correspond with us separately, you should fill in and submit separate application forms, choosing the "Single" option on each one. 

Annual Membership Fees:

ANNUAL FEES for membership are due April 1 of each year.  Fees for new members joining part way through the year will not be pro-rated (our membership fee is low enough as it is!)  However, for new members joining in the first three months of the calendar year, your membership will be in effect until March 31 of the following year.  We prefer you to pay your fees by credit or debit card, but if you wish to pay by cheque, you will be given the opportunity to print a remittance slip after you have submitted the application. You must then mail the printed slip with your cheque to:

Membership Chair
Stephen Leacock Associates
Box 854, Orillia, ON  L3V 6K8

Your membership will be put into effect when we receive your cheque.

Problems?

If you have any problems in submitting your application, please send an email to webmaster@leacock.ca explaining the nature of the issue, and providing your telephone number.