AD~net
Algoma District Community Network
Corporate Office: P.O. Box 688, RR#1, 1 Collver Road. Thessalon, Ontario P0R
1L0 Tel: (705) 842-5808/227 Fax: (705) 842-3747 Email:
admin_adnet@adsab.on.ca
www.adnetalgoma.ca/
The ________________________________________ applies for
membership in the
(Insert name of organization)
Algoma District Community Network (ADnet). The applicants hereby acknowledges
support of the ADnet Vision and Mission statements as published on the ADnet
web site at
www.adnetalgoma.ca.
The applicant organization gives ADnet permission to identify publicly the
organization as member of
ADnet and use the organization’s name and logo on the ADnet website and other
marketing publications.
ADnet will not use personal information without the consent of the individual.
The applicant organization appoints as its representative to ADnet.
The applicant organization appoints as its alternate representative to ADnet.
Enclosed is a cheque in the amount of $500.00.
( ) Please provide information on how individuals in my organization can
participate in the ADnet
Board of Directors.
Authorized by: ________________________________
(Signature)
Name: _______________________________________
(Print)
Position: _____________________________________
Date: ________________________________________
Representative Information
ADnet will use the following personal information for the sole purpose of
keeping ADnet members informed of ADnet activities by mail and electronic
means. ADnet will not convey the information in any manner, shape or form to
any third party for any purpose. ADnet will not sell or give the information
to a third party.
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