2008-09 Subscription Form

Identity

First name
Last name
Email

Shipping address

Institution
Street, PO box
City
Province/state
Postal/zip code
Country

Useful information

Home phone
Work phone
Home fax
Work fax

I want

	regular pass(es) @ $92.00
	senior pass(es) @ $72.00
	student pass(es) @ $35.00

To send

Print this form once it is completed;
Submit the form electronically (see button below);
Mail the printed form, along with your check payable to “Les Boréades de Montréal”, to the address below.

Les Boréades de Montréal
127, 17e Avenue, Lachine, Québec, H8S 3N7
Phone: 514-634-1244
Fax: 514-634-1854
www.boreades.com
njcharbonneau@videotron.ca

Thank you!