MEMBERSHIP APPLICATION
August 2011 - July 2012
 

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Membership Status Requested:
Renewal:                 New:
Type of membership required:*
Corporate:               Personal:
Payment Method:*
Cheque:                  P/O No.:

Name:*

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Institution:*

Mailing Address:*

Phone:*

Fax:

Email:*

Your professional interest in equal opportunities:
Your professional expertise in equal opportunities: