CACSMA Application Form

BECOMING A CACSMA MEMBER

Print and fax to: Johanne Denault, Treasurer

APPLICATION FOR MEMBERSHIP

Membership Category Member Associate Member*

( ) Individual $ 60.00 $ 90.00

( ) Student $ 20.00 $ N/A

( ) Corporate 1 (for-profit corporations) $ 400.00 $ 500.00

( ) Corporate 2 (not-for-profit corporations) $ 250.00 $ 350.00

* Individuals and corporations not residing or located in Canada enjoy all membershi privileges, except the right to vote. ( ) Enclosed is $_______________ Please make cheque payable to CACSMA.
( ) Please invoice for $_______________ An official receipt will be issued.

Name: Title:

Company:

Address: Tel.:

Fax:

Correspondence: ( ) English ( ) French

E:mail: Internet:

Signature: Date:

Corporate-Second designated individual member:

Name: Title:

Membership Classification:
1.Only individual members may vote
2. Corporate members may designate up to two individual members, each having the right to vote.
3. Student members enjoy all membership privileges, except the right to vote. Student members must attend a recognized college or university (photocopy of valid student identification card required).

APPLICATION FOR MEMBERSHIP
Membership Category		Member	Associate Member*

( ) Individual		$ 60.00	$ 90.00
( ) Student		$ 20.00	$ N/A
( ) Corporate 1 (for-profit corporations)		$ 400.00	$ 500.00
( ) Corporate 2 (not-for-profit corporations)		$ 250.00	$ 350.00

* Individuals and corporations not residing or located in Canada enjoy all membershi privileges, except the right to vote. ( ) Enclosed is $_______________ Please make cheque payable to CACSMA. ( ) Please invoice for $_______________ An official receipt will be issued.
Name:	Title:
Company:
Address:	Tel.:
	Fax:
	Correspondence: ( ) English ( ) French
E:mail:	Internet:
Signature:	Date:
Corporate-Second designated individual member:
Name:	Title:
Membership Classification: 1.Only individual members may vote 2. Corporate members may designate up to two individual members, each having the right to vote. 3. Student members enjoy all membership privileges, except the right to vote. Student members must attend a recognized college or university (photocopy of valid student identification card required).