Membership

Membership Fee*

Annual Membership Fee ($25.00)
2021 Fundraising/Membership Drive ($50.00)
2021 Fundraising/Membership Drive ($75.00)
2021 Fundraising/Membership Drive ($100.00)
2021 Fundraising/Membership Drive ($125.00)
2021 Fundraising/Membership Drive ($150.00)

Payment of CANA membership dues are good for (1) year and will expire if renewal payment is not received on or before the 5th day following the anniversary date. Any contributions made above the Membership Dues will be applied to CANA's Fundraising efforts for that fiscal year. Additional contributions can also be made on our " Donate to CANA" and "Donate to Bayles" webpages.

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email

Mobile Phone

Landline Phone

If purchasing household membership, name of other adult(s) in household:

Name of 2nd Adult in Household

First Last

Email for 2nd Adult in Household

Name of 3rd Adult in Household

First Last

Email for 3rd Adult in Household

Name of 4th Adult in Household

First Last

Email for4th Adult in Household

OPTIONAL SECTION

Would you be interested in volunteering?

Yes
No

Do you use Facebook?

Yes
No

Best Time to Attend CANA's Meetings (select one)

Select All
6:30 pm weeknight
7:00 pm weeknight
Saturday morning
Saturday afternoon

Email

This field is for validation purposes and should be left unchanged.

BECOME A MEMBER

CANA Membership Form