Membership Renewal

Member Name (for companies: Name of the Primary Contact for your Company)*

First NameLast Name

Personal Pronouns

For OSM's internal use only.

Company Name (if applicable)

Email at which you would like to be contacted by OSM*

example@example.com

Have any of your details changed since your last renewal or sign-up? If yes, please update your information below to keep your directory listing current.

YesNo

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

E-TransferACH Bank TransferCredit CardCheque

Please select your membership level(s) and quantities of each:

Individual Memberships

Student Membership

This tier is for students who want to begin connecting with Manitoba’s media production industry while completing their studies.

$25.00CAD Quantity

Professional Affiliated Membership

You qualify for this rate if you: * Are an active member of IATSE Local 856, IATSE/ICG 669, ACTRA Manitoba or the Directors Guild of Canada – Manitoba District Council, or * Work for a registered Production Company, Service Supplier or Non-Profit Industry Stakeholder member

$50.00CAD Quantity

Professional Membership

This is the general membership recommended for most working professionals in Manitoba’s media production industry. If you work on set, behind the scenes, in post, in the office or in any production support role, this tier gives you full access to the core benefits of membership.

$80.00CAD Quantity

Professional + Membership

The Professional Plus membership is geared toward experienced producers, writers, directors and filmmakers. This tier is well suited to those seeking to apply for Access Funds for travel to markets, festivals or professional development.

$200.00CAD Quantity

Company Memberships

Non-Profit Organization/Industry Stakeholder Membership

$300.00CAD

Service Supplier Membership

$500.00CAD

Production Company (1 Producer) Membership

$500.00CAD

Production Company (2 Producers) Membership

$1,000.00CAD

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Total

$0.00CAD

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Student ($25)Professional (Affiliated — $50)Professional ($80)Professional + ($200)Non-Profit Organization/Industry Stakeholder ($300)Service Supplier ($500)Production Company (1 Producer — $500)Production Company (2 Producers — $1,000)

Please provide the name of your affiliated member organization.*

School*

Program/Degree/Diploma*

For OSM's internal use only.

If renewing multiple memberships, please indicate each member's name and membership level.

YesNo

Billing Contact Name*

First NameLast Name

Billing Contact Email*

example@example.com

To access membership benefits.To support On Screen Manitoba.To support the development of the media production industry in Manitoba.For a partnership opportunity.Other

Membership Renewal

Payment Information

Please send your E-transfer to payments@onscreenmanitoba.com

Please contact our Operations Manager, Dodie McKay at dodie@onscreenmanitoba.com, (204) 927-5898 to receive our bank transfer information.

Please make your cheque payable to "On Screen Manitoba". Please contact our Operations Manager, Dodie McKay at dodie@onscreenmanitoba.com, (204) 927-5898 if you would like to receive an invoice.

Credit Card