Sign Up or Renew Your Membership by Mail-in Cheque

If you’d like to sign up or renew your membership by mail-in cheque, please fill out the membership information form below and mail a cheque for $10.00 to…

Positive Health Network

c/o Dennis Boyd
140 King Street East, Suite 101, Lower Level, Hamilton, ON L8N 1B2

Cheques should be made out to ‘The AIDS Network’ rather than Positive Health Network until we finalize the transition with the CRA.

Please note, to qualify for membership you must live in one of the regions served by Positive Health Network (Hamilton, Halton, Haldimand, Norfolk, Brant County or Brantford Ontario).

Membership Form

Your Name(Required)

Purchaser Name

Are you a new member or renewing your membership?(Required)

I would like to sign up to become a member.

I am renewing my membership.

Address(Required)

Full Address

Email(Required)

Phone(Required)

Cheque Number(Required)

Cheque Amount(Required)

This field is for validation purposes and should be left unchanged.