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Application for Full Membership

Please read Membership Information and Services before applying; then fill out and print this form or send same information with the materials outlined below to:
The League of Canadian Poets
192 Spadina Ave., Suite 312
Toronto, ON M5T 2C2

Please note:

Name:
Street Address:
City:
Province/State:
Postal/Zip Code:
Country:
Telephone:
Fax:
Email:
Website:

Are you a: Canadian Citizen Landed Immigrant

Are you applying as a: Print Poet Spoken Word/Performance Poet.
Select the category that most applies to you.

Please mail four copies of your poetry book, chapbooks, CDs, tapes, DVDs or videos; a literary c.v. or biography and bibliography.
Title of work:

Are you an Associate, Supporting or Student member of the League? If so, please specify: ___________________