Membership Application For more information click here. First Name Last Name Date of Birth Gender Male Female Address City Province Choose... Ontario Postal Code Phone Number Email Select all that apply Colostomy Ileostomy Urinary Diversion Continent Ileostomy Continent Urostomy Spouse/significant other Ileoanal Pouch I am unable to pay at this time but would like to be a member How did you learn about the Hamilton & District chapter? Make cheques payable to: Hamilton & District Ostomy Association Mail to: 2-558 Upper Gage Ave., Suite 116 Hamilton,Ontario L8V 4J6 An affiliated Chapter of the United Ostomy Association of Canada Inc. A Non-Profit Canadian Charitable Organization: Registration Number: 118951417 RR0001 Apply