Welcome to ISNA Membership Registration Form

ISNA Canada Membership Registration Form

Thank you for being part of the ISNA Canada community! Whether this is your first time, or you're in the process of renewing, we're happy to have you as one of our Members! Please fill out the form below and we will get back to you regarding the status of your membership. For any questions or concerns regarding membership, email membership@isnacanada.com
Member Personal Information
Membership Status*

NewRenew
Membership ID (optional)
Name*

First NameLast Name
Email Address*
Note: Members must have a UNIQUE email address and cannot use the same as another member.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Date of Birth*

MonthDayYear
Gender
References Information

We kindly request you to please provide us with two current ISNA members' (with at least two (2) consecutive years of membership) contact information as your references.
Reference 1

First NameLast Name
Reference 1 Phone Number

Area CodePhone Number
Reference 2

First NameLast Name
Reference 2 Phone Number

Area CodePhone Number
Membership Eligibility Claim

For applicants to be eligible for their membership they must have had contributed 50 volunteer hours, $500 in donation, or a combination of both, within the last 12 months.
Please Select the desired option to obtain your membership*
Number of Volunteer Hours
Donation Amount
Donor Email
If you are not the main donor, please provide the name of the donor under which the donation has been made
Donor Name
If you are not the main donor, please provide the email of the donor under which the donation has been made
Volunteer Events or Program Name
Event/Program Lead Name

First NameLast Name
Low Income/Physical Impairment claim

Cancelof
I declare I am 18+ or as a parent/guardian of a member below the age of 18, I give consent to the individual under my care to sign up as a member of ISNA Canada (a parent must check the box below on behalf of their child signing up) and I declare that all provided information is accurate, to the best of my knowledge, and I agree to keep ISNA Canada up to date of my information. I agree that the information I have provided may be used to contact me regarding ISNA Canada Membership. I agree to the membership conditions as outlined in the current by-laws of ISNA Canada
I agree with the above statement
Should be Empty:

ISNA Canada Membership Registration Form

Member Personal Information

References Information

Membership Eligibility Claim