You selected to pay your EVA BC core membership by cheque

Please complete your agency's information below

Agency Name *
Your Name *
Your Phone *
Your Email *
Agency Mailing Address *
City *
Province *
Postal Code *
Community-Based Victim Services (CBVS) *
Stopping the Violence Counselling (STVC) *
Stopping the Violence Outreach Services (STV ORS) *
Multicultural Outreach Services (MORS) *
Sexual Assault Services (SAS) *
Total number of Core Member Program staff:

EVA BC core membership fee structure:

TierTotal number of staff in EVA BC core member programsAnnual membership dues
310 or more$900

Please select the matching membership tier below to see your dues total:

Membership Tiers *
Total Amount

You will receive email confirmation for your payment, but you may want to save or print this page for your records.