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Application for Membership

For

At^lohsa Native Family healing Services Inc.
109-343 Richmond Street
London, Ontario
N6A 3C2

 

Thank you for your interest in becoming involved as a member of At^lohsa Native Family Healing Services Inc.

We are asking people who are interested in becoming a member to please fill out the following questionnaire.  This helps us to know what you background, skills and interests are.

We appreciate your interest and time in filling out this questionnaire.  The Secretary to the Board will get back to you as soon as possible to discuss your future membership with At^lohsa Native Family Healing Services Inc.

 

In Unity & Friendship

 

President

 

 

 

 

 

 

At^lohsa Native Family Healing Services Inc.
109-343 Richmond Street
London, Ontario
N6A 3C2

Membership Application

I, the undersigned have made application for membership to At^lohsa Native Family Healing Service Inc.  (hereinafter called the “Corporation”) acknowledging that membership in the Corporation shall be limited to persons interested in furthering that objects of the Corporation and being made up of those persons whose application for admission as a member of the Corporation has received the approval of the Board of Directors of the Corporation.

I further acknowledge that no membership fees or dues are required unless otherwise directed by the Board of Directors of the Corporation.

I further acknowledge that as a member of the Corporation, I shall remain liable for payment of any assessment of other sum levied of which becomes payable by myself to the Corporation before acceptance of my resignation by the Board of Directors of the Corporation.

I further acknowledge that as a member of the Corporation, I may be expelled or suspended or required to resign by a vote of three-fourths (3/4ths) of the members at an annual meeting or a special meeting called for that purpose.

As a member of the Corporation, I shall be entitled to one vote on each question arising at any special or general meeting, and at the annual meeting of the members of the Corporation.

Name

 

Address

 

Member’s Signature

 

For Office Use Only

Authorized Signature

 

Date Approved

 

At^lohsa Native Family Healing Services Inc.
109-343 Richmond Street
London, Ontario
N6A 3C2

Membership Application

NAME

 

ADDRESS (Please include your postal code)

 

TELEPHONE NO.

Work:

Home:

DATE

 

OCCUPATION

 

I understand that the mission of this Corporation is to provide for the healing and recovery of First Nations families in a culturally sensitive and balanced circle of health intervention.  I also understand that the objects (purposes) of the Corporation are:

  1. To gather and process information concerning all aspects of Native family and community violence.
  2. To promote awareness and provide education and counseling in the Native communities throughout Ontario concerning all aspects of Native family and community violence.
  3. To provide aid to victims of Native family and community violence throughout Ontario.
  4. To liaise with existing and future victims of violence committees.
  5. To develop and operate prevention and treatment programs.
  6. Such other complimentary purposes not inconsistent with these objects.

 

I understand that the by-laws of the Corporation state that membership in the Corporation is limited to those persons interested in furthering the objects of the Corporation and I agree that I am willing and able to help further the objects of the Corporation.
 

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