PAUPER PARTY OF ONTARIO
CONSTITUENCY ASSOCIATION
REGISTRATION FORM
Constituency Association _______________________ No.:_____
We, the undersigned members, do consent to act as the Interim Executive of the
Pauper Party of Ontario until elections are held within 60
days of reaching 100 members.
President: Print: ______________________ Sign: _____________________________
Address: ______________________________________________________________
Tel/fax: ____________________________ Email: _____________________________
Secretary: Print: _____________________ Sign: ______________________________
Address: ______________________________________________________________
Tel/fax: ____________________________ Email: ____________________________
Financial Officer: ____________________ Sign: ______________________________
Address: ______________________________________________________________
Tel/fax: ____________________________ Email: _____________________________
Internet Officer: _____________________ Sign: ______________________________
Address: ______________________________________________________________
Tel/fax: ____________________________ Email: _____________________________
Dated at ___________________________ on ________________________________
Return to Pauper Party of Ontario, 50 Brant Ave. Brantford ON N3T 3G7