Membership Form TestPage


    Online Membership Application Form


    Name & Contact:

    City CentreDufferinAberdeenUpper SahaliLower SahaliSun RiversJuniperRayleighBrocklehurstNorth ShoreWestsydePineviewBachelorReserveValleyviewOther...

    (Note: The public Members Directory will only include Name, Locale, Photo and secure, private Contact link.)

    Information below will be kept private. For office use only.



    Home Address:

    A. Directory: May we include you in our online Members Directory? YesNo
    B. First Aid: Do you hold a current first aid certificate? YesNo
      Do you have training in current CPR techniques? YesNo
    C. Image Use: May we use your images for KPAC promotional purposes? YesNo
    D. Primary Camera: NikonCanonPentaxOlympusSonyFujiOther...

    E. Primary Software: PhotoshopLightroomPS ElementsPicasaAffinityOther...

    F. Experience Level: BeginnerIntermediateAdvancedProfessional

    A. Membership Fee: $20 Will be paid via: Direct BillingeTransferChequeCash

    (NOTE: Direct Billing means you will accept an invoice from Interior Savings Kamloops and will pay your membership fee online.)

    Please type to confirm your consent for Direct Billing.

    B. Membership Application Data: No ChangeChangedNew Member

    Please send a profile image to the Membership Director:
    Maximum file size 100KB - Resolution 100x100 pixels.
    Check the Members Directory for examples.