Corporate Membership Application

Thank you for your interest in being a member of the Grand Bend Area Community Health Centre (GBACHC) corporation. Members elect the board of directors, appoint the auditor, and vote on proposed bylaw changes and special resolutions.

Approved memberships are valid for three years.

Before completing a membership application, please visit the GBACHC website to ensure you support the corporation’s mission, vision, and core values.

Today's Date(Required)

First Name(Required)

Initial

Preferred Name

Last Name(Required)

Residential & Mailing Address(Required)

Street Address PO Box City Province Postal Code

Email(Required)

Membership Eligibility (Select all that apply)(Required)

I live permanently or seasonally, or work in the Grand Bend or Hensall areas.

I support the GBACHC mission, vision and core values

I am 18 years old or older

The Grand Bend Area Community Health Centre (GBACHC) is a non-profit, community-governed organization that provides comprehensive primary health care and interprofessional health services.

Grand Bend Area Health Services Foundation

The Grand Bend Area Health Service Foundation (GBAHSF) is a charitable organization that undertakes fundraising for the GBACHC. It receives and distributes funds necessary to assist with capital requirements.

Learn More

Contact Us

Grand Bend Site
69 Main Street East, Box 1269
Grand Bend, Ontario N0M 1T0
519-238-2362

Hensall Site
122 King Street, Box 159
Hensall, Ontario N0M 1X0
519-262-3140