Membership Form - Friends of ROSSS Friends of ROSSS enjoy voting rights at our AGM, the Friends of ROSSS annual breakfast, our annual focus group, and so much more! Fill out the application below to join the Friends of ROSSS today! Membership dues are $25 Annually. 1Personal Identification2Interests3Consent4Payment Information Full Name(Required) First Last Email(Required) Date of Birth(Required) MM slash DD slash YYYY Full Address(Required) Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Gender(Required) Man Woman Non-binary Two-spirit Prefer not to say None of the above. I identify as: I identify as: Would you be interested in volunteering for ROSSS? If so, in what role?What interests you about ROSSS membership?Are you currently a caregiver/accessing any of ROSSS' services? If so, which ones?Is there anything you would like us to know about you? (eg. accessibility needs) Do you consent to ROSSS sharing your name and email with other members?(Required)Do you consent to your photo being included in ROSSS social media, newsletters, and marketing products?(Required)Consent(Required) I agree to allow a representative from Rural Ottawa South Support Services to contact me using the provided contact information. Friends of ROSSS Membership (One-Year) Price: Total Payment MethodPayPal CheckoutCredit Card MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name
