Print the form and mail to:
Scott Fraser Fan Club
PO Box 28060
Dartmouth, Nova Scotia
Canada B2W 6E2
Print Clearly. Please include Postal or ZIP Code.
Name:___________________________________
Address: ________________________________
City: ____________________________________
Prov./ State:_______________
Postal/ ZIP Code:___________
Country: __________________
Birthday (M/D/Y): ___________________
Daytime Phone: ____________________
Evening Phone: ____________________
E-Mail Address: ____________________
I wish to receive Newsletter via (check one):
E-Mail ______ Post mail _______
New Membership: ______ Membership Renewal: _______
Current or Past Membership #:______________________
Membership Dues:
$15.00 Canadian per person (Canadian addresses only)
$12.00 U.S. International per person
Payment Type:
Check ______ Money Order: _______ Made payable to "Scott Fraser Fan Club"
All memberships will Expire on one year anniversary of activation, i.e. July
1, 2002- July 1, 2003. Please allow 4-6 weeks for processing & delivery.
Please "Print Clearly" and remit form to:
Scott Fraser Fan Club
PO Box 28060
Dartmouth, Nova Scotia
Canada B2W 6E2