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Membership Application
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Canada's Premier Malt Whisky Appreciation Society
You are hereby invited to become a Companion of the Order of The Quaich, A League of Ladies and Gentlemen Who Enjoy the Finest Things in Life
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| Prov: | Postal Code: |
| Office Tel: | Office Fax: |
| Home Tel: | Home Fax: |
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| (Optional) My birthday is:(Month) (Day) | |
Attached is my cheque in full payment for:
Initiation fee ($40) plus one year's annual dues ($50) Total: $90 ___
Initiation fee ($40) plus two year's annual dues ($90) Total: $130 ___
Date:_______________________________________
Please complete and mail to:
ED PATRICK
206 - 19 DUNDONALD STREET
TORONTO, ONT.
M4Y 1K3
