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AFOA Membership

Corporate Membership

Organization Information


Organization Name:

Street Address:

City:	Province/Territory:	Postal Code: A#A #A#

Designated Member #1


Name:		Postion/Title:

Phone: ###-###-####		Fax: ###-###-####		Email:

Designated Member #2


Name:		Postion/Title:

Phone: ###-###-####		Fax: ###-###-####		Email:

Membership Type

A corporation is permitted to become a corporate member at either the National or the Chapter levels, or both. The two designated members for the corporation are transferable. Membership dues are based on the calendar year from January 1 to December 31 and can be prorated. For any inquiries, please contact our office at toll-free (866) 722-2362.

Please indicate at which level you would like to become a corporate member:

AFOA National Corporate Membership:
AFOA Canada Corporate Membership: $1,000 plus GST per calendar year.

AFOA Chapter Corporate Membership (where available):
AFOA ON Corporate Membership: $1000 plus GST
AFOA SK Corporate Membership: $750 plus GST
AFOA BC Corporate Membership: $1,000 no GST
AFOA AB Corporate Membership: $1,000 no GST
AFOA MB Corporate Membership: $750 plus GST

Payment

Corporate Membership:	$

GST*:	$	#883195927RT0001

Total Amount Due:	$

Method of Payment:
Cheque (payable to AFOA Canada)
VISA
Mastercard
American Express

Please send cheques to the following address:

AFOA Canada
1066 Somerset Street West, Suite 301
Ottawa, ON K1Y 4T3

Credit Card Information (if applicable):

Cardholder Name:

Credit Card Number:

Expiry Date:

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