MASC Membership Apply/Renew Online

Please fill in the from below to register your MASC Membership. Fields noted with the red asterisk are required. Fields that do not apply to your organization may be left blank.

New Registration or Renewal(Required)

New Registration

Renewal

Name of Organization(Required)

Organization Address(Required)

Street Address Address Line 2 City Province Postal Code

Organization Phone(Required)

Organization Email(Required)

Organization Website

Organization Mission Statement

Number of Members as of April 1st

Does your organization have an elected community board?(Required)

Yes

#1 Contact Information - Board Member/Staff

Name(Required)

First Last

Position(Required)

Phone

Email (If different than the email provided above.)

#2 Contact Information - Board Member/Staff

Name

First Last

Position

Phone

#3 Optional Contact Information

Name

First Last

Position

Phone

Current Activities

Current activities conducted by your organization. Check all that apply.

Activities

Health and Wellness Programs

Education Programs

Social Events

Food Programs (congregate meals, special lunches, etc.)

Transportation Services

Support Groups

Other

MASC Membership

MASC's membership year runs from April1 - May 31. The $100 membership fee is due by May 31 of the membership year. (It is possible to prorate this fee for the first year only.) Cheque is to be made payable to MASC. Please ensure your centre/group name appears on the cheque. Forward with this application to:

MASC Membership
Attn: C Newman, Executive Director
PO Box 54067 Silver Heights PO
Winnipeg, MB R3J 0L5

Would You Like a Membership Certificate Mailed to You?(Required)

Yes

Hidden

MASC Admin Area

Hidden

Has this Member Paid?

Yes

Hidden

Has Membership Certificate Been Mailed?

Yes

Hidden

Notes:

Membership/Renewal

#1 Contact Information - Board Member/Staff

#2 Contact Information - Board Member/Staff

#3 Optional Contact Information

Current Activities

Other Questions

MASC Membership

MASC Admin Area