Membership Form - Social Workers in Health Society of BC

Membership Form - Social Workers in Health Society of BC


We invite you to renew your membership or to join our Society.
Name: _________________________________________________________________________
Degree: ________________________________________________________________________
Job Title:_______________________________________________________________________
Employer:______________________________________________________________________
Employment Address:_____________________________________________________________
Preferred Mailing Address: _______________________________________________________
Phone (Home): ______________________    (Work): _____________________
E-mail Address:__________________________________________________________________
Special Interest Area(s): __________________________________________________________
Check one:    New Member: _______   Renewal:________   Student:_______
I am interested in becoming a mentor________
Signature: _________________________________________________________
Membership cost: $40.00 ($20.00 student)

Mail cheque to: (make payable to Social Workers in Health Society of BC)
   Social Workers in Health Society of BC
   Kingsway R.P.O.
   P.O. Box 79006
   Vancouver, B.C.  V5R 5Z6

Membership year: April 1st – March 31st
For further information contact: Nicky Coutts  E-Mail: membership@socialworkersinhealthbc.org
Check out our new website at: www.socialworkersinhealthbc.org