Membership Membership in the Langley Pos-Abilities Society has various privileges. Please fill out this form and click "Submit Application" to become a member. You may donate via Interac e-transfer or credit card. Please contact us if you prefer another donation method. Name* First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone*MobileEmail* COMPANY(optional)MEMBERSHIP CATEGORY* Person with a disability Family member Community member Caregiver Volunteer Other VOLUNTEER AREA OF INTEREST and/or TALENT*Membership* Price: $ 15.00 CAD Donation Donation Method*Interac e-TransferCredit CardSending an e-transfer donation via your online banking system is easy. 1. Log in to your financial institution's online or mobile banking and navigate to Interac e-Transfer Send Money. 2. Select the account you would like funds transferred from. 3. Add or select "Langley Pos-Abilities Society" and e-mail address "zosia@pos-abilities.org" 4. Type in the specified amount you are sending, along with a personalized message such as: "Annual membership donation" in the message area. 5. Click "Send" button.Credit CardWe use Square to process credit card information. For details visit https://squareup.com/ca/en Cardholder Name Card Number Expires CVV / CVC Postal Code Total $ 0.00 CAD CaptchaCommentsThis field is for validation purposes and should be left unchanged.