Boundary Mining Association
Box 2443

Grand Forks, B.C. V0H 1H0
email John Jewitt  at  john.jewitt@shaw.ca   

Membership Form:   2012  Dues $30.00 (individual)   Corp. $100.

Name:

 

Company:

 

Address:

 

Address:

 

City:

 

Province/State:

Postal/Zip Code:

 

Phone - home

Fax:

Phone - work

Email:

Please complete the following:

  Engineer

Geologist

Prospector

Hardrock Miner

Placer Miner

Driller

Service/Supplier

Investor

Interested Person

Exploration Co. Director/Employee

  Other

           

 Comments:                                                                                                                                

                                                                                                                                               

                                                                                                                                    

Signature                                                                      Date

We prefer to send out all correspondence to our members by email.
If you have provided your email address, we will not be sending mailouts by regular mail, 
unless you specifically request that we do so.

 

Date paid:_____________

 Receipt #______________