CITIZENS FOR RENEWABLE ENERGY

Ziggy Kleinau Co-Ordinator R.R. #4 Lion's Head Ontario N0H 1W0 Phone/Fax: (519) 795-7725 http://www.cfre.ca cfre at web.ca

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Membership form for Citizens For Renewable Energy

A general membership will give you quarterly newsletters with updates on the latest developments. A sustaining membership will also give you discounts on CFRE events and publications.

Date ____________________

Name ______________________________________________________________

Address ____________________________________________________________

Postal Code ____________________

Phone # ____________________________ Fax # ___________________________

Email _______________________________________________________________

Please check the appropriate choices:

new membership	renewal

general 1 year $15 ($8 for unwaged)	sustaining member 1 year $25	general 3 years $40

Special Category: Life Membership $300

Please print and mail a copy of this form along with a cheque made out to
Citizens For Renewable Energy to the address above.