ASSOCIATION MEMBERSHIP APPLICATION
1. Corporate Information
Association Name _________________________________________________________________________________________
Doing Business As___________________________________________________________________________________________
Address____________________________________________________________________________________________________
City ____________________________________________ Province ________________ Postal Code___________________
Telephone ______________________________________ Fax _____________________________________________________
Website____________________________________________________________________________________________________
Language of correspondence
English
French
2. Primary Contact
Mr.
Mrs.
Ms.
Dr.
Name __________________________________________ Title_____________________________________________________
Address____________________________________________________________________________________________________
City ____________________________________________ Province _____________ Postal Code______________________
Telephone ______________________________________ Fax _____________________________________________________
Email______________________________________________________________________________________________________
Language of correspondence
English
French
3. Invoice Recipient
Mr.
Mrs.
Ms.
Dr.
Name __________________________________________ Title_____________________________________________________
Address____________________________________________________________________________________________________
City ____________________________________________ Province _____________ Postal Code______________________
Telephone ______________________________________ Fax _____________________________________________________
Email______________________________________________________________________________________________________
Language of correspondence
English
French
4. Areas of Interest
Please rank your top three and mark other areas of interest with a check mark.
Aboriginal Affairs and Canada’s North
Intellectual Property
Science and Technology
Canada-U.S.
Internal Trade
Skills and Immigration
Competition Policy
International Affairs
Small- and Medium-sized Business
Environment
Labour Relations
Tourism
Fiscal Policy
Natural Resources and Energy
Transportation
Infrastructure
Responsible Business Conduct
Innovation
Retirement Savings
Other areas of policy interest:________________________________________________________________________________
Top countries/regions your association and members do business in:
1. _________________________________ 2. _________________________________ 3.____________________________________
5. Officers of the Association
List the two highest-ranking association officials to be contacted.
Name __________________________________________ Title_____________________________________________________
Address____________________________________________________________________________________________________
City ____________________________________________ Province _________________ Postal Code__________________
Telephone ______________________________________ Fax _____________________________________________________
Email______________________________________________________________________________________________________
Preference of correspondence
Name __________________________________________ Title_____________________________________________________
English
French
Address____________________________________________________________________________________________________
City ____________________________________________ Province _________________ Postal Code__________________
Telephone ______________________________________ Fax _____________________________________________________
Email______________________________________________________________________________________________________
Preference of correspondence
English
French
6. Membership Investment
Annual Investment ______________+ applicable taxes (HST Registration # 106844285)= _________________________ Total
Invoice me
Cheque attached
Visa
MasterCard
Amex
Credit Card No. _______________________________________ Expiry Date _______________________________________
Name ________________________________________________ Telephone ________________________________________
Cardholder’s Signature_____________________________________________________________________________________
Account Manager, Corporate Relations_____________________________________________________________________
7. Type of Industry
Accommodation
High Technology
Printing & Production
Advertising, Marketing & Communications
HR & Payroll Services
Real Estate & Development
Agriculture
Importing & Exporting
Retail Trade
Arts, Entertainment & Recreation
Legal Services
Skilled Trades
Construction & Engineering
Logging & Forestry
Transportation & Warehousing
Finance & Insurance
Manufacturing
Utilities
Food & Beverage Services
Media
Wholesale Trade
Health Care & Social Services
Mining, Oil & Gas
Other Business Services
8. List of Committees*
Our association members are encouraged to participate on our committees and task forces. It is through your
input that we are able to effect change on your behalf. (Please indicate name of association representative for
each committee of interest.)
Business Law
Innovation
Name:_______________________________________________
Name:_______________________________________________
Title: _________________________________________________
Title: _________________________________________________
Email:________________________________________________
Email:________________________________________________
Competition Law and Policy
Intellectual Property
Name:_______________________________________________
Name:_______________________________________________
Title: _________________________________________________
Title: _________________________________________________
Email:________________________________________________
Email:________________________________________________
Economic Policy
International Affairs
Name: ______________________________________________
Name:_______________________________________________
Title: _________________________________________________
Title: _________________________________________________
Email:________________________________________________
Email:________________________________________________
Human Resources Policy
Natural Resources and Environment
Name:_______________________________________________
Name:_______________________________________________
Title: _________________________________________________
Title: _________________________________________________
Email:________________________________________________
Email:________________________________________________
Immigration Policy
SME
Name:_______________________________________________
Name:_______________________________________________
Title: _________________________________________________
Title: _________________________________________________
Email:________________________________________________
Email:________________________________________________
Indigenous Affairs
Taxation
Name:_______________________________________________
Name:_______________________________________________
Title: _________________________________________________
Title: _________________________________________________
Email:________________________________________________
Email:________________________________________________
Territorial Policy
Ottawa Liaison
Name: _____________________________________________
Title: ________________________________________________
Email:_______________________________________________
Transportation & Infrastructure
Please provide me with
more information
(VP or equivalent level)
Additional fee applies.
Name: ___________________________________________
Title: ______________________________________________
Email:_____________________________________________
Name: _____________________________________________
Title: ________________________________________________
*Subject to eligibility
Email:_______________________________________________
9. I would like more information on:
Advertising opportunities
Events
BIAC Canada
International Arbitration
Board of Directors
Membership in a local chamber of commerce
Canadian Chamber of Commerce background
information
Membership in a prov./territorial chamber of commerce
Canadian Intellectual Property Council
Sponsorship opportunities
Canadian Services Coalition
Policy committees
Thought Leadership Series Roundtables
Carnet and Document Certification
Any personal information provided on the attached form will be used by the Canadian Chamber of Commerce,
as set out in our Privacy Policy, to conduct the transaction indicated on this form. Please consult our Privacy Policy,
available online at Chamber.ca or contact our Privacy Officer at [email protected] or 613.238.4000 (229).
Thank you for filling out this form. Please send it to the location nearest you.
Chamber.ca | [email protected] |
Ottawa
420 - 360 Albert Street
Ottawa, ON K1R 7X7
T: 613.238.4000
F: 613.238.7643
CanadianChamberofCommerce |
Toronto
901 - 55 University Avenue
Toronto, ON M5J 2H7
T: 416.868.6415
F: 416.868.0189
Montreal
560 - 999 Boulevard de
Maisonneuve Ouest
Montreal, QC H3A 3L4
T: 514.866.4334
F: 514.866.7296
@CdnChamberofCom
Calgary
PO Box 38057
Calgary, AB T3K 5G9
T: 403.271.0595
F: 403.226.6930
ANNUAL ASSOCIATION MEMBERSHIP FEE SCHEDULE
We are pleased to offer the following association membership options:
Option A - $750
Includes access to information, applicable engagement, the opportunity to be listed on the Canadian
Chamber of Commerce website as a member in good standing, and invitations to two annual
association roundtables.
Option B - $1,500
In addition to Option A, includes eligibility to be represented on Canadian Chamber of Commerce
policy committees with the exception of the Ottawa Liaison Committee, and staff access to all
cost-saving affinity programs.
Option C - $2,500
In addition to Option B, includes eligibility to be represented by the CEO or equivalent on the Ottawa
Liaison Committee and on any appropriate ICC, BIAC/OECD, Global Business Coalition committees
(*additional fees may apply).
Option D - $5,000
In addition to Option C, includes the opportunity to work collaboratively on major policy messages,
participation in an annual “Ten Ways to Build a Canada That Wins” planning session, and invitations to
the annual Crystal Ball Symposium and Crystal Ball report launch event.
Note: Associations in the Option B, C and D categories will be eligible to reduce their fees by 10% if the
CEO agrees to send a letter or other such message to association members promoting the merits of
Canadian Chamber of Commerce corporate membership.
Annual Membership Fee
SUBTOTAL _____________________
*plus applicable taxes _____________________
TOTAL FEE
_____________________
*The applicable tax rate will be based on the province/territory in which the association head office is located.
Outside of Canada, 15% HST applies.
AB, BC, MB, NT, NU, SK, YT: 5% GST | QC: 5% GST + 9.975% QST | ON: 13% HST | NB, NL, NS, PE: 15% HST
HST Reg. #106844285 | QST Reg. # 1006090296