Green Marine Partner Membership Form (CAD)

FORMULAIRE D'ADHÉSION - Participant

Programme de certification environnementale de l’Alliance verte
Company *
Corporate overview*
Address

Street Address

Street Address Line 2

CityProvince (Add official province abbreviation: BC, AB, SK, MB, ON, QC, NB, NS, PE, NL)

Zip CodeCountry
Green Marine contact person within your organization*

First nameLast name
Title*
Email*
Phone*
Contact person within your company to handle European requests (if applicable)? This contact will be added to your partner profile on the Green Marine and Green Marine Europe websites.

First nameLast name
Email
Phone
Which partners' category better suits your activities?*

Engineering and environmental consultingEnergy companiesShippers, Logistics & Ship managersIndustry services, products & technology providersPilotageR&D, response, training & cooperativeCassification societies, verification & vetting services
Eligibility statement *
Briefly explain how your product or service contributes to better environmental performance.
Keywords that are relevant to your organization.
These words will inform the search engine and will be linked to your partner profile in our directory of environmental products and services (e.g. bilge water, engineering, GHG, LNG, recycling, etc.). Consider consulting the Green Marine program to identify the most relevant keywords for participants.
Communications

Yes, add my email to the Green Marine distribution list (you can unsubscribe or manage your preferences as you wish).
Date*

MonthDayYear
Number of employees (The rates provided below encompass the entirety of the remaining months in 2023 and the entire year of 2024. Your membership will remain valid until December 31, 2024.)
prevnext( X )
Partner - 50 employees or lessplus applicable taxes (linked to your address)
$782.00CAD

Partner - More than 50 employeesplus applicable taxes (linked to your address)
$1,305.00CAD

Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

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FORMULAIRE D'ADHÉSION - Participant