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.

"*" indicates required fields

Name*

First Last

Address*

Street Address Address Line 2 City Province Postal Code

Phone*

Mobile

Email*

COMPANY

(optional)

MEMBERSHIP CATEGORY*

Person with a disability

Family member

Community member

Caregiver

Volunteer

Other

VOLUNTEER AREA OF INTEREST and/or TALENT*

Membership*

Price:

Donation

Donation Method*

Interac e-Transfer

Credit Card

Sending 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 Card

We use Square to process credit card information. For details visit https://squareup.com/ca/en

Cardholder Name

Card Details

Total

Captcha

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

Welcome to Langley Pos-Abilities Society

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