Individual Membership (New)Application Name* First Last Position | Title*Organization*Organization Type*Federal GovernmentProvincial GovernmentMunicipal GovernmentEducational InstitutionHealth Care AuthorityCrown CorporationPrivate Sector OrganizationMailing Address* Street Address City Postal Code Province or Territory*Select from dropdown listNewfoundland & LabradrNova ScotiaNew BrunswickPrince Edward IslandQuebecOntarioManitobaSaskatchewanAlbertaBritish CoumbiaNorthwest TerritoriesNunavutYukonTelephone #*Fax #Email Address* Alternate Email Membership Option*This form is for new members only. To renew a membership Select Renew Membership from Membership Page. New MemberWilling to Volunteer?Chapter ExecutiveChapter CommitteeNational ExecutiveGuest SpeakerSponsorNo Thank YouPrivacy StatementSend me IPMA Canada event notifications, newsletters, marketing or other membership material?*YesNoCan IPMA Canada provide your name and mailing address to other organizations so that you can receive relevant HR professional development or HR information materials. No email address will be provided.*YesNoDo you grant permission to have your name, work address and email provided to other members of the organization for networking purposes i.e. Membership Directory*YesNoPaymentSelect a Chapter:*National includes members from BC, Que, PEI where there are currently no chapters. Cost $125 + GST/HSTAlberta & NorthSaskatchewanManitobaNational Capital RegionGreater TorontoNova ScotiaNew BrunswickNewfoundland & LabradorNational15% HST $ 0.00 CAD 5% GST $ 0.00 CAD 13% HST $ 0.00 CAD 12% HST $ 0.00 CAD Total $ 0.00 CAD Payment Options:*Pay online now with Credit CardPay by eTransferCredit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Expiration Date Security Code Cardholder Name Pay by eTransfer: Please email your payment now to: firstname.lastname@example.orgCAPTCHANameThis field is for validation purposes and should be left unchanged.