Membership Request

Membership

•Reg.: 25$ CAN./year or 25$US (bank fees includes)
•5 years: 100$ CAN. or 100$US (bank fees included)
•Benefactor: 50$ CAN. and more/year

Important :

Please note that the option “complete online”  is not functional so, click on the link below and follow instructions…

Click here to download printable pdf file

Association des familles Demers inc.

and mail care of:

Luc Demers, Trésorier
1190 chemin Vire-Crêpes
Lévis, Qc, Canada G7A 2B2
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PLEASE NOTE THAT SOME FIELDS ARE MANDATORY

    Member Number (in case of a renewal)

    Last Name (mandatory)

    First Name (mandatory)

    Spouse last name

    Spouse first name

    Address (mandatory)

    City (mandatory)

    Postal code (ZIP)(mandatory)

    Country (mandatory)

    Phone Home

    Phone Work

    Birthplace

    Birthdate (yyyy-mm-dd)

    Wedding place

    Wedding date (yyyy-mm-dd)

    E-mail (mandatory)

    MY PARENTS

    Father's last name

    Father's first name

    Mother's last name

    Mother's first name

    Wedding place

    Wedding date (yyyy-mm-dd)

    THE SPOUSE'S PARENTS

    Father's last name

    Father's first name

    Mother's last name

    Mother's first name

    Wedding place

    Wedding date (yyyy-mm-dd)

    MY GRANDPARENTS

    Father's last name

    Father's first name

    Mother's last name

    Mother's first name

    Wedding place

    Wedding date (yyyy-mm-dd)

    THE SPOUSE'S GRANDPARENTS

    Grand Father's last name

    Grand Father's first name

    Grand Mother's last name

    Grand Mother's first name

    Wedding place

    Wedding date (yyyy-mm-dd)

    MY GREAT GRANDPARENTS

    Great Grand Father's last name

    Great Grand Father's first name

    Great Grand Mother's last name

    Great Grand Mother's first name

    Wedding place

    Wedding date (yyyy-mm-dd)

    THE SPOUSE'S GREAT GRANDPARENTS

    Great Grand Father's last name

    Great Grand Father's first name

    Great Grand Mother's last name

    Great Grand Mother's first name

    Wedding place

    Wedding date (yyyy-mm-dd)