Application for Membership

APPLICATION FOR MEMBERSHIP

TO: The Board of Directors, BATTLE RIVER RAILWAY NGC INC.

(the “Cooperative”)

c/o 5009-50th Ave Forestburg, AB T0B 1N0

[insert complete name of applicant] of

, in the Province of Alberta (herein referred to as “I” and the

“Applicant”) hereby apply for membership in the Cooperative.

A. PERSONAL INFORMATION

1. My mailing address is:

2. My telephone number is:

3. My SIN/BN is:

4. My email address is:

B. ADDITIONAL INFORMATION (complete only if the business you will be conducting with

the Cooperative is not being carried on as one individual, or a sole proprietorship owned

by one individual).

I wish to own shares in joint names with another or I am a corporation or partnership which is

entitled to apply for a membership. My delegate until further notice will be:

Name of delegate:

Address:

Telephone No. Fax No.

Email address:

C. OTHER APPLICANT INFORMATION

I represent and warrant the following information to be true: (please complete where indicated)

(a) My complete name is correctly set forth above (provide any other names by

which are known):

(b) Qualify for membership under the by-laws and are accepted as members in the

Cooperative by the Board of Directors.

INITIALS: _____