Membership Online

Breast Cancer Action Kingston

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Serving Kingston & South Eastern Ontario

613 531-7912

Membership - Online

MEMBERSHIP is renewable on an annual basis (January to December) for a fee of:

Basic: $30.00 for an individual (survivor or supporter), family of survivor (at the same address) or a charitable organization. Tax receipt provided.
Gold: $50 includes Exercise,Yoga and Chestmates (Chestmates must be a breast cancer survivor)Tax receipt provided for $30

Corporate: $50.00 for agencies and corporations/organizations.

All membership payments are deemed donations and a charitable tax receipt will be issued.

Step 1: Please complete the form below:

Charity number: 89056 7241 RR0001

Select One Membership Option

Basic $30

Gold $50

Family $30

Charity $30

Corporate $50

Gold includes $30 membership + Exercise, Yoga, Chestmates

Please choose the one that best describes you:

Survivor

Caregiver / Support / Member of Public

Company or Agency

I am interested in volunteering

Please list the services you are interested in from BCAK

Non Mandatory Information

In order to direct information to specific groups, please complete the following. It is not mandatory to fill out this section. All personal information remains confidential. Thank you.

Age Category

Under 40

Over 40

Over 65

Physical Activity Level

High

Moderate

Low

Your interest in Group Outings/Events/Retreats

High

Moderate

Low

Do you suffer from Lymphedema?

Yes

I'm Not Sure

Thanks for submitting!

Thank you for completing Step1 and submitting the Membership Form for our records. Please continue to STEP 2 to pay for your membership online.

Step 2:

To Pay for your membership online, please select the appropriate secure payment button here.

Please note you may also use e-transfer as your choice of payment. See instructions on previous page.

Continue

NOTE: Our monthly newsletter is normally sent via email. If you have no email address and wish it mailed to you, please contact the office.

All personal information collected remains confidential. As a member of BCAK you will automatically become a subscriber to the monthly newsletter. If you are NOT interested in receiving the monthly newsletter, please contact the office.

For more information call (613) 531-7912, or e-mail: office@bcakingston.ca

Breast Cancer Action Kingston

Office Hours: Tuesday – Friday 12:00 - 4:00

110-650 Dalton Ave, Kingston, ON K7M 8N7
Telephone: 613.531.7912
Registered Charity# 890567241RR0001