Group Application

Complete this form to apply for membership.

Name of group

Address

City

Province or Territory

Telephone

Fax

To be completed by group representative.

First Name

Last Name

Group Representative Email

Tell us about your group.

All members of our group are required to take the following Basic/Introductory Collaborative Training:

Does your group have any on-going educational requirements for members?

Membership Payment

Group size

Your payment of $0.00 for one membership year is based on a total of 2 members in your group, at a fee of $50.00 per member.

Choose a payment option

Note: Our Newsletters and information about Webinars and other relevant topics are provided via e-mail. To receive member e-mails from us, please leave this box checked. You can unsubscribe at any time.

Your application will be reviewed by our team and you will be notified via email.