Until May 31, 2009, retirees belonging to Member Associations of CURAC/ARUCC may join CARP (or existing CARP members may extend their memberships) at the discounted rates given below (25% off advertised membership fees). After May 31, 2009, members of CURAC/ARUCC Associations will continue to receive a discounted fee, but then based on the higher CARP membership and subscription fees that will affect others from April 1. If you wish to join CARP (or extend your membership) at this special CURAC/ARUCC rate, please complete and send in the following form before May 31, 2009. CARP Registration 2009 – CURAC 09 Last Name: ________________________________________________________________ First Name: ________________________________________________________________ Initial: _______________ Address: __________________________________________________________________ City: ___________________________________________ Province: _______________________________________ Postal Code: __________________________ Spouse Name: ______________________________________________________________ Phone Number: __________________________________ Email: _____________________________________________________________________ Date of Birth (optional): ___________________________ ‡ One Year Membership and subscription to Zoomer magazine ($14.95) [$26.21 after May 31] ‡ Three Year Membership and subscription to Zoomer magazine ($44.85) [$78.64 after May 31] ‡ Cheque enclosed, payable to CARP (Please do not send cash.) ‡ Charge my ‡ Visa ‡ MasterCard ‡ AMEX Credit Card Number ____________________________________ Expiry Date ___/___ Signature _______________________________________ ‡ I prefer not to be contacted by CARP‐recommended suppliers. Mail to: CARP 27 Queen Street East, Suite 1304 TORONTO, ON M5C 2M6 RECEIPT CURAC 09 Received from: _____________________________________________________ the sum of ______________________________________________ /100 dollars Amount: _____________________ For: _________________________________ Date: ____________________ Signed: __________________________________