Egyptian Canadian Coalition for Democracy
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ECCD Membership Form
Name
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Please let us know your name.
Address
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City
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Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
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Ontario
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Quebec
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Northwest Territories
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Postal Code
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Country
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Canada
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
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Belarus
Belgium
Belize
Benin
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Chile
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Dominican Republic
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Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
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Guinea
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Hungary
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India
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Ireland
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
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Latvia
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Liberia
Libya
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Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (Burma)
Namibia
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Niger
Nigeria
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Norway
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Papua New Guinea
Paraguay
Peru
Philippines
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Portugal
Qatar
Romania
Russia
Rwanda
St. Kitts and Nevis
St. Lucia
St. Vincent and The Grenadines
Samoa
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Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
UK (United Kingdom)
USA (United States of America)
Uruguay
Uzbekistan
Vanuatu
Vatican City (Holy See)
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
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Email
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Please let us know your email address.
Gender
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Male
Female
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Phone
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I am willing to volunteer in:
Promote the organization, sign up members and communicate with current members
Organize and/or help out with social events
Organize and/or help out with youth events (educational programs, camps and sports)
Administrate ECCD social media (i.e. Facebook page, Twitter profile, etc.) and website
Speak to media, meet with politicians, prepare letters, press releases & reports
Other:
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How many hours are you willing to volunteer every week?
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In your view, what are the most pressing prioritizes for ECCD...
.. in the next 3-12 months?
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... in the next 1-3 years?
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(*)
I declare that I am eligible to be a member of the Egyptian Canadian Coalition for Democracy (ECCD) and that I am paying my own membership fees. I also declare that I support the ECCD principles and agree to abide by them.
In order to become a member, you must accept this condition.
Membership Fee Payment
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Adult Yearly - 120.00 CAD
Adult Quarterly - 30.00 CAD
Adult Monthly - 10.00 CAD
Student Yearly - 30.00 CAD
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