Individual Membership Form – Timberline Community Housing

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I have read and agree to the Qualifications, Roles and Responsibilities of membership in the South East Community Services Co-operative.

See website for details: https://timberlinehousing.ca/southeast-community-services-co-operative/membership-declaration/

Applicant Name

First

Last

Only 1 Applicant per Form

Address

Phone Number

Email Address

By entering my email address, I give permission to SECSC to communicate with me about membership related activities and/or project updates.

Signature

* Typing your name qualifies as your signature for the purposes of this Agreement

Signature Date

Who referred you to become a Member?

Payment – After submitting this form, e-transfer your 1-time payment of $10.00 to payments@secsc.ca to finalize your Membership.