BCPWSA :: Membership & Donations

By becoming a member of the BCPWSA, we will be able to keep you informed, and provide you with the support you need!

Please fill out the following form completetly, and we will get back to you as soon as possible.

Your Information
First Name:
Last Name:
Address:
City:
Province:
Postal Code:
Telephone:
Fax:
Email:
PWS Individual's Information
Name of person with PWS:
Address (if different from above):
City (if different from above):
Province (if different from above):
Postal Code (if different from above):
Date of Birth:
I can be contacted by professionals doing research:
I can be contacted by other families:
My child's name can be included on the membership list:
I am interested in getting involved with BCPWSA activities:
I will be submitting my membership fee ($25/family - not tax deductible):
Comments and/or questions:
To verify, please enter the characters you see in this image: