Any Canadian affected by a familial ataxia can complete the following form to be a member of the foundation at no cost. Anyone who makes an annual donation of $ 20 or more is automatically a member.

Member privileges :

  1. to be convened to annual general meetings, to vote and to be elected;
  2. to be represented, within the Association limits, to government authorities;
  3. to participate in the movement of the Association dedicated to the promotion and mutual aid of its members;
  4. to be in contact with a network of people aware of hereditary ataxias.

Membership Form

New MemberRenewal

MrsMr
First Name* Last Name*
Organization
Address* City*
Province* Postal Code *
Phone* E-mail*
Birthdate Type of Ataxia
Member Status
AtaxicRelativeSpouseFriendSympathizerHealthcare providerOrganization

I agree to adhere to the mission and values of Ataxia Canada.*

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