PARTNER CAD MEMBERSHIP FORM

FORMULAIRE D'ADHÉSION - Participant

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

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Green Marine contact person within your organization *

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

Engineering and environmental consulting Energy companies Shippers, Logistics & Ship managers Industry services, products & technology providers Pilotage R&D, response, training & cooperative Cassification 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.
Number of employees *
prev next ( X )
Partner - 50 employees or less Choose your province in the dropdown menu
$ 753.00 CAD

Partner - More than 50 employees Choose your province in the dropdown menu
$ 1,257.00 CAD

Total

$ 0.00 CAD
Date *

Month Day Year

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.

Should be Empty:

FORMULAIRE D'ADHÉSION - Participant