BC Aboriginal Network on Disability - Resource Centre

BC Aboriginal Network on Disability Society

Resource Centre Borrower Application

This registration form tells us the minimum we need to know before we can lend you materials. We will not release this information, and we will never use it for any other purpose.

When you submit the form, we will return a page suitable for printing. We must ask you to mail or FAX that page because your signature is required for registration as a patron.

Name:
Job title:		You must be employed to register as a borrower
Company or Organization:
Mailing Address:
(addr. line 2):
City:
Province:		(BC residents only, please)
Postal/Zip:
Telephone:		(enter "none" if no telephone)
FAX:		(enter "none" if no FAX)
E-mail:		(enter "none" if no e-mail)