RFANS Annual Membership Application

RFANS 2023-24 Annual Membership Application

For Annual Renewals and New Members
Date

MonthDayYear
Date
Facility, Corporate, or Educational Institution Name*

Legal NameShort Name
Name of Applicant*

First NameLast Name
New Membership or Renewal?*
Please note: Memberships are renewed annually and follow the fiscal year (April 1st to March 31st).
Address*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Please list ALL municipal facilities covered by Municipal Membership

Please also provide contact information for all facility operators.
Facility Name Contact Person Phone Number Email

Operator's Name Operator's Email
Facility Name Contact Person Phone Number Email

Operator's Name Operator's Email
Facility Name Contact Person Phone Number Email

Operator's Name Operator's Email
Facility Name Contact Person Phone Number Email

Operator's Name Operator's Email
Facility Name Contact Person Phone Number Email

Operator's Name Operator's Email
Facility Name   Contact Person                  Phone Number   Email

Operator's Name   Operator's Email
Facility Name Contact Person Phone Number Email

Operator's Name Operator's Email
Facility Name Contact Person Phone Number Email

Operator's Name Operator's Email
Opt in for RFANS Monthly Newsletter
If you are renewing your membership, how long have you been a member with RFANS?
How would you like to pay?*

Master CardVisaAmerican ExpressPayPalInvoice
Method of Payment

Master CardVisaAmerican ExpressPaypalDebitInvoice Me
My Products
prevnext( X )
Individual/Student Membership (Student)Individual Membership (Students or a person not directly associated to a facility but is interested infacility operations)
$85.00CAD Quantity
Item subtotal:$0.00CAD



Facility MembershipPrivate/Board operated facilities/Universities
$200.00CAD



1 Municipal Facility MembershipFor 1 municipal facility (please list the name of the facility and the operator below)
$200.00CAD



2-5 Municipal Facilities MembershipFor 2-5 Municipal Facilities (please list all facilities and their operator's in field below)
$300.00CAD



6+ Municipal Facilities MembershipFor 6 or more Municipal Facilities (please list all facilities and their operator's in the field below)
$500.00CAD



Corporate MembershipAny business, supplier or not for profit
$250.00CAD Quantity



Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD

Should be Empty:

RFANS 2023-24 Annual Membership Application

Please list ALL municipal facilities covered by Municipal Membership