Membership Renewal FormPERSONAL INFORMATION UPDATE

PLEASE PRINT CLEARLY AND COMPLETE EACH SECTION

Membership Number: ___________________________ Date of Last Renewal: (dd/mm/yy):__________________First Name: __________________________ Last Name: ___________________________ Middle Initial(s): _____
Address_______________________________________________________________________________________
City: ____________________________________ Province: ___________________ Postal Code: ____________
Date of Birth dd:____ mm:____ yyyy:_______ Place of Birth: ___________________________________________
Phone: ____________________ Work: ____________________ Mobile:__________________ Fax: ____________
Email Address: _____________________________________ Website: ___________________________________TYPE OF MEMBERSHIP RENEWAL FULL - Any person of Aboriginal descent within the meaning of s35(2) of the Canada Act, 1982 but NOT aband member residing on a reservation.
 YOUTH - Same as FULL membership only applicant is under 18 years of age.

 ASSOCIATE - Non-Status Indians, Status Indians or Individuals with Band Memberships who live on a reservation.

MEMBERSHIP FEES

SELECT YOUR PAYMENT

1 yr Renewal: 

2 yr Renewal: 

3 yr Renewal: 

4 yr Renewal: 

5 yr Renewal: Full: $15.00

Fee: $30.00

Fee: $45.00

Fee: $60.00

Fee: $60.00

Youth: $5.00

Fee: $10.00

Fee: $15.00

Fee: $20.00

Fee: $20.00

Associate $10.00

Fee: $20.00

Fee: $30.00

Fee: $40.00

Fee: $40.00*Please Note - Youth Memberships may only be renewed in if the applicant will remain under the age of 18 forthe full term of renewal.

PHILANTHROPYWOULD YOU LIKE TO MAKE A DONATION TO OMAA-THE WOODLAND MÉTIS TRIBE?

 I would like to pledge $______ annually / monthly (please circle one) in support of Rights Based
Challenges, Métis Student Bursaries, or other Métis Cultural Programming.
METHOD OF PAYMENTTotal: $_________PLEASE MAKE CHEQUES OR MONEY ORDERS PAYABLE TO OMAA-THE WOODLAND MÉTIS TRIBE

Payment Type:  Certified Cheque Money OrderOATH
I hereby make application for membership with the Ontario Métis Aboriginal Association – The Woodland Métis Tribe and do
swear that all of the information contained herein is true to the fullest extent of my knowledge. I understand that providing
false statements or impersonating another individual within this application is considered a criminal act and will be punished to
the fullest extent of the law. Should my application be accepted, I further agree to abide by the Constitution and By-Laws of
OMAA - The Woodland Métis Tribe, along with all future amendments and pay the annual membership fees specified to me
within this application. I understand that my membership may be revoked at any time, should I fail to adhere to the guidelines
set within the Membership By-Laws. In the event that my card is lost, stolen or damaged, I agree to pay a $5 replacement fee.

Signature of Applicant: ______________________________________ Witness: _________________________________ Date: _____________COMPLETE THE ABOVE AND MAIL PAYMENT ALONG WITH ONE PASSPORT-STYLE OR PHOTO BOOTH PHOTO* TO:OMAA - The Woodland Métis Tribe
203 Hardisty Street
Thunder Bay, Ontario
P7C 3G8
CANADAIf you have any questions or need assistance with filling out this form, please phone us at: +1 (807) 622-5249*NOTE: PLEASE DO NOT SEND PHOTOS PRINTED ON REGULAR PAPER. DO NOT SEND CROPPED, RETOUCHED orOTHERWISE DITGITALLY ALTERED PHOTOS. SENDING PHOTOS OTHER THAN THE REQUESTED FORMAT WILLRESULT IN YOUR APPLICATION BEING DELAYED UNTIL THE APPROPRIATE TYPE OF PHOTO IS RECEIVED.