Boundary Mining Association
Box 2493,
Grand Forks, B.C. V0H 1H0
email John Kemp rainex@shaw.ca   or Manfred Flury  uflury@hotmail.com

Membership Form:   2009 Dues $20.00 (individual)

Name:

 

Company:

 

Address:

 

Address:

 

City:

 

Province/State:

Postal/Zip Code:

 

Phone - home

Fax:

Phone - work

Email:

Please complete the following:

□  Engineer

□ Geologist

□ Prospector

□ Hardrock Miner

□ Placer Miner

□ Driller

□ Service/Supplier

□ Investor

□ Interested Person

□ Exploration Co. Director/Employee

 □ Other
           

 Comments:                                                                                                                                

                                                                                                                                               

                                                                                                                                    

Signature                                                                      Date

We prefer to send out all correspondence to our members by email.
If you have provided your email address, we will not be sending mailouts by regular mail, 
unless you specifically request that we do so.

 

Date paid:_____________

 Receipt #______________