Printable Membership Order Form ___________________________________________________________________________ Title: Mr. Ms. Mrs. Dr. Name: _________________________________________________________ Company/Institution: _________________________________________________________ Department: _________________________________________________________ Street Address: _________________________________________________________ City: _________________________________________________________ Province/State: _________________________________________________________ Country: _________________________________________________________ Postal Code/Zip Code: _________________________________________________________ Phone: _________________________________________________________ Fax: _________________________________________________________ Email: _________________________________________________________ Website Address: _________________________________________________________ _____________________________________________________________________________________ You may pay by Paypal or credit card by clicking on the Paypal buttons below Please indicate category chosen: * This is a one-time contribution; payment may be made over a three year period and a tax receipt issued. ** Available on request. Different categories of SESCI membership provide varying benefits but all members receive: Annual subscription to Sol; Member rates to SESCI Conference and events. SESCI's membership list is not sold. 1. Student $20 2. Senior Citizen (Over 60) $35 3. Individual $65 4. Library $100 5. Corporate (5 or less employees) $175 6. Corporate (6 or more employees) $350 7. Supporting Corporate $1500 8. Sustaining Lifelong (Individual)* $3000 ISES (Intn'l Solar Energy Society)** You can also print this out and send it in with your payment. Payment: Cheque/Money Order Visa/Mastercard Amount Included:______________________________________________________________________ Credit Card number:____________________________________________________________________ Expiration Date (month/year):____________________________________________________________ Signature: ___________________________________________________________________________   Please return to: Solar Energy Society of Canada Inc. McLaughlin Hall 406 Queen's University Kingston ON K7L 3N6 Canada Email: info@sesci.ca Web: www.sesci.ca

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