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As
a member of the TSAO you will be entitled to receive
a regularly published newsletter, attendance and
voting rights at the annual general meeting of
the Association and all other rights and privileges
afforded members of the Association.
NAME:______________________________________
ADDRESS:___________________________________
CITY:______________POSTAL
CODE_____________
PHONE:_______________E-MAIL________________
Visa Card Number:____________________________
Expiry Date:______
American Express Number:_____________________
Expiry Date:______
Signature:_________________________
Date:_____________________________
I
would like information as it pertains to:(circle
all that apply)
Patient
Parent Teacher
Physician
(specify)___________________________
Other
(specify)______________________________
Annual
Membership Fee $25.00. Please make Cheques payable
to the "Tourette Syndrome Association of
Ontario".
Please Print, Fill Out and Return to: The Tourette
Syndrome Association of Ontario, 20 Procee Circle,
RR#1, Barrie, Ontario, L4M 4Y8
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