R.E.T.A. Registration Form

R.E.T.A Membership

Please enter your name and email addresses plus the names and email addresses of your family members.
Indicate which individuals are 18 years or age or older:

	First Name	Last Name	18+	Email 1	Email 2
1.
2.
3.
4.
5.
6.

Please enter your address:

Apartment #:
House Number:
Street Address
City/Town
Province
Postal

Please enter your phone number(s):

Daytime:

()

Evening:

()

Mobile:

()

RETA is an all volunteer organization but it costs money to advertise, print flyers, rent meeting space, maintain a web page and so on. Your assistance would be greatly appreciated.

I Would like to contribute financially to RETA
I would like to volunteer time to help RETA