CATIE Organizational Membership Form

Membership is free and is perpetual.


CATIE membership lists are completely confidential. They are not provided, traded, rented or sold to any organization. We do use an external distribution house for all printed materials. Only names and addresses are provided to the distribution house and lists are destroyed after each mailing.


* Required field


Organization Contact Information

Organization Name*

Name of Executive Director or equivalent

Address 1*

Address 2

City*

Province/Territory*

Postal Code*

Phone

E-mail

Language of Correspondence*

Information about the voting representative for your Organization

Salutation*

First Name*

Last Name*

Job Title

E-mail*

This e-mail address will be used to send you member communications.

Phone

Extension

Fax

Gender

Date of Birth

 /   ( DD / MM )

Day and month of birth is used only to distinguish between multiple members with the same name and to prevent duplicate membership records. Your year of birth is not required.

Language of Correspondence*

Sector

We are collecting this information to better understand the diversity within our membership, for statistical purposes, and to help us notify you of the most relevant information and resources. All information you provide will be kept confidential. Please tell us as much as you are comfortable sharing.

Catchment

Organization Categories









Areas of Work

I am
(Check all that apply)
 

I provide services for:
(Check all that apply)
 

Please tell me about resources that are:
(Check all that apply)
























Aboriginal Membership

i.e. your organization is run by a majority of Aboriginal persons and serves primarily Aboriginal persons.

Free Subscription Services

You can also subscribe to these publications without becoming a CATIE member at: http://orders.catie.ca/subscription/subscribe.shtml.

The subscription selections you submit in this form will override all previous selections. Please ensure to complete your subscription selections below to continue receiving your choice of free publications.

E-mail Services

Please sign me up for the following e-mail services. (Don't forget to give your e-mail address in the contact information section above.)

CATIE's bi-weekly HepCInfo Updates aim to make hepatitis C scientific findings more accessible by highlighting links to key prevention, harm reduction, treatment, support and epidemiology information in a single easy-to-use and regular e-mail.
Toolkit highlighting successes and lessons learned from Canadian HIV and hepatitis C front-line programs.
Regular reports on resources and services from CATIE and other organizations across Canada. Includes news, events, job postings and more.
CATIE's flagship treatment digest has kept Canadians current and on the leading edge in HIV and HCV research and treatment for more than 18 years. Approximately 7 issues per year. Receive e-mail notification when it's online.
Practical information and tips to help maintain your physical, mental, emotional, spiritual and sexual health. Two issues per year. Receive e-mail notification when it's online.
Brief, focused updates on new and important developments in HIV.
Highlights on prevention research and how it can be integrated into the planning and provision of services.

Print Subscription– free and offered only in Canada

Practical information and tips to help maintain your physical, mental, emotional, spiritual and sexual health. Receive two printed issues per year.

By submitting this membership application, I confirm that our organization wants to be an Organizational Member of CATIE and that we support CATIE's knowledge exchange work.


CATIE strives to use terminology that reflects the way stakeholder groups would like to be described. We welcome your feedback regarding the terminology used in this form. Please contact us with your suggestions at: descriptions@catie.ca

Donations

Should you wish to make a donation in support of CATIE's work, there are several secure and convenient options.


If you have any questions about your CATIE Membership, please telephone: 1-800-263-1638 extension 267 or e-mail at: membership@catie.ca.


If you wish to update your contact details (for example, your mailing address), please contact us by email at info@catie.ca or by telephone at (416) 203-7122 or 1-800-263-1638.


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