Home Join OTANS Form
Primary Information:* Required Fields:
Company Name: *
Address:
City:
Province/State:
Postal/Zip Code:
Country:
Telephone:
Fax:
Secondary Address: (if applicable)
Address:
City:
Province/State:
Postal/Zip Code:
Country:
Telephone:
Fax:
Company Information:
Email: *
Website:
Company Profile:

(Please include a 50 word description of your company for our website. This information allows our members to better understand what your company does.)
Categories:
(Maximum of 10)

To select mulitple categories hold down the 'Ctrl' key while making your selections.
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NOTE: Only your first 10 categories will be selected.
Password: *
Verify Password: *
# of Employees: *
Comments: (Internal)
Type of Member:
FULL MEMBERSHIP:
Fees categorized by number of employees.
Fee: 1 - 10 Employees $441.00 (plus HST)
Fee: 11 - 50 Employees $661.50 (plus HST)
Fee: 51 or more Employees $882.00 (plus HST)
STUDENT MEMBERSHIP:
Fee: $42.00 per year + HST *Subject to change.

Billing Information:
Credit Card #:
Expiry Date:  
Card Holders Name:
 
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