Official C.B.D.A. Gift Order Form
Your Name: ____________________________________
Address: ____________________________________
City/Town: ____________________________________
Province: ____________________________________
Postal Code: ____________________________________
Name of recipient: ____________________________________

Complete the address

below only if you want the gift shipped directly to recipient.
Address: ____________________________________
City/Town: ____________________________________
Province: ____________________________________
Postal Code: ____________________________________

Special membership package with fashion option (hat included)

                           ___   $23.95 = _________

Basic membership package (hat not included)

                           ___   $15.00 = _________

Official C.B.D.A. Hat (embroidered logo)

                           ___   $15.95 = _________

Shipping charges add $5.00

                                                = _________

(free shipping on orders over $50.00)

                                  TOTAL = _________


Please make cheques or money orders payable to Canadian Beer Drinkers’ Alliance Ltd. 

Send orders to Canadian Beer Drinkers’ Alliance Ltd. Box 877, Sutton West, Ontario, L0E 1R0

Postage may be higher for orders outside Canada. Please allow four to six weeks for delivery.

Official C.B.D.A. Gift Order Form
Information about recipient required for gift membership letter. Please print clearly.
Recipient is of legal drinking age:  Yes___  No ___
Sex:  M___  F___
Usual first name: __________________
Nickname or pet name: _____________________
Special occasion (e.g. 40th birthday): ________________________________________
Membership is being sponsored by name(s): ___________________________________
Your relationship to recipient (e.g. friend, aunt etc.): _____________________________
Years of beer drinking: _____________
Any special beer related experiences: ________________________________________
_____________________________________________________________________
_____________________________________________________________________
Hobbies/Interests: _______________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Any other information that you might wish to have included in the note from Elmo:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________