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Name__________________________________________
Address________________________________________
City/town______________________________________
Province_____________________Postal Code_________
Phone(____)____-_____
Signature_______________________________________
Date________________

Membership categories
Individual $20 (    )              Students/Seniors $15 (   )
Family $30 (   )   Affiliate $60 (   )   Corporate $120 (   )
I would like to donate $_________
Donations to Transport 2000 Atlantic are tax-deductible.
Please make donations and membership dues on separte
cheques.

I am interested in:
Urban transit (  )            Rail (  )
Bus           (  )             Air (  )
Marine        (  )           Other ___________________

I would like to be active in Transport 2000
activities (   )

Please make cheques payable to:
Transport 2000 Atlantic
P.O. Box 268
Dartmouth, N.S., B2Y 3Y3