Yes, I want to join the growing movement against noise pollution and for the recognition of my Right to Quiet. I also want to receive the twice-yearly newsletter. Here are my annual dues for 200__.

The Right to Quiet Society for Soundscape Awareness and Protection is a registered charitable society. All contributions are tax-deductible in Canada, and a receipt for income tax purposes will be sent.

If you live in Canada, please pay by cheque in Canadian funds. If you live in another country, pay the same amount in U.S. funds, by cheque on a U.S. bank or international money order.

Annual dues are payable in January. If you are joining the Society after July 1, you may pay half the amount quoted below.

Single	$12.00
Family	18.00
Student/Senior/Low-income	6.00
Business	50.00
Non-profit organization	25.00
Additional contribution	________
TOTAL

My additional contribution is $25 or more. Please send me (tick one):

___ Right to Quiet t-shirt, size ________ (Actual size sent depends on availability)

___ "What You Can Do About Noise in B.C." handbook and "I Love Quiet" bumper sticker

Name	_______________________________________________
Address	_______________________________________________
City	_______________________________________________
Province/State	_______________________________________________
Country	_______________________________________________
Postal/Zip Code	_______________________________________________
Telephone	_______________________________________________
Fax	_______________________________________________
Email	_______________________________________________

For more information, please contact:
Right to Quiet Society
#359 - 1985 Wallace St.
Vancouver, B.C.
Canada V6R 4H4

Phone: (604) 222-0207
E-mail: info@quiet.org

If you would like, use the rest of the paper to tell us a bit about yourself or offer other comments.