ANNUAL MEMBERSHIP REPORT

ANNUAL MEMBERSHIP REPORT

Please complete the 2011 Membership Report for your organization before 9 April 2012.

The report is also available to download here in PDF format.

Should you have any additional questions or concerns about this membership report, please contact Devon Allison, Membership and Communications Officer.

Fields marked with * are mandatory

ORGANIZATION INFORMATION

1. The following information should be completed by the person responsible for working with WFM IS staff on membership, advocacy and financial issues.

WFM Organization Name: *

Contact Officer's Name:

Office/Role:

Organization Address:

City:

State/Province:

Postal Code:

Country:

Organization Website:

Organization Email Address: *

Organization Phone Number:

Organization Fax Number:

2. Please note the full names of your organization's most senior officers in the applicable spaces.

President:

Vice President:

Board/Council Chair:

Board/Council Vice Chair:

Executive Committee Chair:

Executive Committee Vice Chair:

Membership Committee Chair:

Policy Committee Chair:

Programs Committee Chair:

Treasurer:

Secretary:

Executive Director:

Attachment	Size
2011 Membership Report.pdf	64.87 KB

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