Please download and print this form.
You may print in Black & White.
Complete this form and mail it, along with your cheque payment or credit card info to:
Burlington Conservative Association
P.O. Box 85053
Burlington ON L7R 4K3
If paying by cheque, make it payable to Burlington Conservative Association
If you pay by credit card your card info will be securely handled.
Your membership information and payment will be transferred to the Conservative Fund Canada on your behalf.
Download (PDF, 113KB)