Corporate Membership Form

Workforce/Workplace Initiaitives
Do you currently have a program that fits into one of the key UWI themes? (Diversity, Equity, and Inclusion, The Future of Work or Leadership & Culture)

YesNo
If No, what is your planned implementation schedule?
Will you provide a link to theuwi.com on your website?

YesNo

Corporate Commitment

Our rates are calculated based on the size of the employee population of your organisation.
How many people does your company employee?*
Latest data available
I understand that this application is a commitment to membership. My corporation will be invoiced upon date of acceptance and begin receiving membership benefits immediately.
Date*

DayMonthYear
Date
Signature*

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UWI:Hub Users

Please provide the details for the users you would like to give access to the UWI:Hub
User 1 *
Full name
Email Address
Street Address

Street Address Line 2

LocationState / Province

Postal / Zip Code
Job Role
User 2*
Full name
Email Address
Street Address

Street Address Line 2

LocationState / Province

Postal / Zip Code
Job Role
User 3 (if applicable)
Full name
Email Address
Street Address

Street Address Line 2

LocationState / Province

Postal / Zip Code
Job Role
User 4 (if applicable)
Full name
Email Address
Street Address

Street Address Line 2

LocationState / Province

Postal / Zip Code
Job Role
User 5 (if applicable)
Full name
Email Address
Street Address

Street Address Line 2

LocationState / Province

Postal / Zip Code
Job Role
User 6 (if applicable)
Full name
Email Address
Street Address

Street Address Line 2

LocationState / Province

Postal / Zip Code
Job Role
Should be Empty:

Primary Contact