HOUSE OF GORDON (CANADA)

MEMBERSHIP APPLICATION

Annual Dues $20.00 Payable to:
"House of Gordon (Canada)"
13 Inverlyn Cres. N., Kincardine Ont. N2Z 1H5

 

Membership N0. ____

 NAME
(Please Print) Last, First, Middle

ADDRESS:

TELEPHONE RES. BUS.

EMAIL

FAMILY SPOUSE

CHILDREN

OCCUPATION

HOBBIES/INTERESTS

MY CLAN AFFILIATION (IF SURNAME IS NOT GORDON OR SEPT)

(Give surname descended from and relationship)


(SIGNATURE)    (DATE)

I WOULD BE INTERESTED IN ASSISTING IN THE ADMINISTRATION
OR THE HOUSE OF GORDON (CANADA) YES , NO ??
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