Become a Member

Thank you for your interest in joining Hemophilia Saskatchewan's membership. We will keep you informed about upcoming events and fundraisers, and available services.

Two ways of joining:

Fill out the form fields below (save yourself the hassle of snail mail); or
Print the Membership Form and mail to Hemophilia Saskatchewan

Membership Form
File Size:	14 kb
File Type:	docx

Download File

ONLINE MEMBERSHIP FORM

* Indicates required field

Name *

First

Last

STREET ADDRESS *

City *

Email *

Province *

Postal Code *

Phone Number *

How would you like to receive the Quarterly Newsletter? *

Email Deliver to my home address Neither...I read it on your website

Family Members (please list immediate family)

Name *

First

Last

Relation *

DOB (DDMMYY) *

M/F *

Type of Bleeding Disorder *

Name *

First

Last

Relation *

DOB (DDMMYY) *

M/F *

Type of Bleeding Disorder *

Name *

First

Last

Relation *

DOB (DDMMYY) *

M/F *

Type of Bleeding Disorder *

Name *

First

Last

Relation *

DOB (DDMMYY) *

M/F *

Type of Bleeding Disorder *

Submit