Older Adult Centres’ Association Of Ontario

Membership Renewal Form 2006-2007

MEMBERSHIP INFORMATION: Please make any changes necessary so records are up to date

MEMBER ____________________________________________________________________________

CONTACT ___________________________________________________________________________

POSITION ___________________________________________________________________________

ADDRESS ____________________________________________________________________________

________________________________________ POSTAL CODE ____________________

TELEPHONE _____________________________ FAX ______________________________________

E-MAIL __________________________________ WEBSITE _________________________________

MEMBERSHIP CATEGORY____________________________________________________________

TYPE OF CENTRE(Please check) Municipal ___ Non Profit ___ Other –please identify_______________

Membership size in 2005 _____ The fee an individual would have paid to be a member of your centre in 2005 ______

OACAO FEE SCHEDULE FOR 2006-2007

(Please check the appropriate level)

FULL MEMBER CENTRE (Annual Gross Expenditures – based on total funds spent to run your centre)

Gross Annual Expenditures Fee

_____ $0 - $50,000 $285

_____ $50,0001 - $150,000 395

_____ $150,001 - $350,000 540 AMOUNT

_____ $350,001 - $500,000 590 PAID

_____ $500,001 - $750,000 735

_____ $750,000+ 845 $ _________

_____ Associate Agency $205

_____ Service Provider/Club $105

_____ Individual/Student/Volunteer/ $ 60

_____ Senior/Friend $ 60

Please make cheque payable to the Older Adult Centres’ Association of Ontario (OACAO)

and return payment and completed form to:

Older Adult Centres’ Association of Ontario

43 North Riverdale Drive Inglewood, Ontario L7C 3K3

Toll Free: 1-866-835-7693 Local: 905-838-0240 Fax: 905-838-1053