MEMBERSHIP APPLICATION

Effective the Date of Signature on Back of Form

CONGRESS OF BLACK WOMEN OF MANITOBA INC.

1425 Manitoba Avenue, Winnipeg, MB R2X 0L5
Phone: (204) 775-4378
Email: cobwmb@gmail.com
Website: www.cobwmanitoba.com

NAME: _________________________________________________________________________

ADDRESS: _____________________________________________________________________

POSTAL CODE: _________________________________________________________________

PHONE NUMBERS: HOME: ______________BUS. : ______________CELL:_________________

EMAIL: _________________________________________________________________________

We are looking for volunteers to serve on committees. Tick the one(s) on which you would be willing to serve.

 MEMBERSHIP  FINANCE  SCHOLARSHIP  FUNDRAISING  PROGRAMS  PUBLICITY/PROMOTION

Please check which area may be of interest to you:

 Public Speaking and Personal Development  Arts and Culture

 Computer Skills  Facilitation Skills
 Administrative Support  Employment
 Financial Management  Health Care
 Other (Please Specify) _______________________________________________________________

Membership Fee: (Regular) $ 30/year; Student (Registered in Educational Programs): $10/year: $_________
Donations are Accepted: $ _________
Total Amount: $ _________

Mission: Forged from a common heritage, common struggles and a common endeavor, and recognizing
that self-respect and self-esteem are important to proper development of our people, the Congress of Black
Women of Manitoba Inc. is non-profit organization dedicated to enhancing the awareness, education, and
rights of Black Women and their families in Manitoba. This is done through the delivery of programs and
projects, informed by meaningful dialogue and geared to serve the needs, hopes and aspirations of Black
Women and their families.
__________________________________________________________________________________________________
Please make cheques payable to: The Congress of Black Women of Manitoba Inc.
Mail completed form and cheque to: Membership Director
Congress of Black Women of Manitoba Inc.
1425 Manitoba Ave
 Winnipeg, MB R2X 0L5
Why we are requesting your signature permission to contact you is to begin our compliance
with the new Bill C-28 which became active on 1 January 2013:
Federal privacy legislation, the Personal Information Protection and Electronic Documents Act
(PIPEDA), sets out the rules for the collection, use and disclosure of such personal information,
and these continue to apply under the new Act. Under PIPEDA, an organization may not
collect personal information without the knowledge or consent of an individual unless the
information is publicly available (according to regulations). In addition, the organization must
state the purpose of the collection of that information.
Bill C-28: Canada's Anti-Spam Legislation
What is spam?
Spam can be defined as any electronic commercial message sent without the express or
implied consent of the recipient(s). Spam is also used as the vehicle for the delivery of other
online threats such as spyware, phishing and malware. (In our case it is any item that
requests you to purchase something, ie: membership or fundraising)
What about text messages or "cellphone spam"? Is it covered?
Yes. The legislation takes a technology-neutral approach, so that all forms of commercial
electronic messages can be treated the same way. That means that unsolicited text
messages, or cellphone spam, are addressed.
Are there exceptions, as with the National Do Not Call List (DNCL), for political
parties and charities?
The legislation does not apply to non-commercial activity. Political parties and charities
that engage Canadians through email are not subject to the legislation if these
communications do not involve selling or promoting a product.
There are also further exemptions for situations where such organizations engage in
commercial activities with people who have made a donation or gift in the last 24 months,
volunteered or performed volunteer work in the last 24 months, or were a member of the
organization in the last 24 months. These exceptions apply to registered charities, political
parties and candidates in federal, provincial, territorial or municipal elections.
If you are raising funds for charitable or other non-profit purposes, you must ensure that
your messages are truthful and accurate in order to avoid potential concerns under the
Competition Act.
----------------------------------------------------------------------------------------------------------------
I ____________________________________________________________ ___________________________________
PRINT DATE
give the Congress of Black Women of Manitoba, Inc. permission to contact me
electronically, via regular mailings and by any and all my related phone
numbers.
______________________________________________________________
SIGNATURE