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

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

(Program Development cannot be selected alone)


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://www.catie.ca/en/about/media/subscriptions.

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.)

Free print subscription to The Positive Side magazine

All materials are mailed in plain brown envelopes.

The Positive Side, our health and wellness magazine written by and for people living with HIV, is also available as a free print subscription to Canadian residents only.

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: info@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 259 or e-mail at: info@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.