CANSBE Jr. Member Information Form

CANSBEJr. Member Information Form
Member Information
Name*

First NameLast Name
Preferred Name*
Birthdate *

MonthDayYear
Age *
Preferred Email*
example@example.com
Allergies*
If none, please type N/A.
School Information
Grade*
School *

Guardian Information
Guardian Information*
Member Availability & Extra-Curricular Activities

Please fill out the information to the best of your knowledge.
What day(s) are you(student) available throughout the week?

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Please list extra-curricular activities. *

Membership Dues

NSBE Jr. National Dues
Are you(student) a National Member? *
If you are not a National Member, use the link below to create {preferredName}'s NSBEConnect Account.

NSBE | Join PCI Initiative

CANSBE Jr. Advisors will be notified once account has been created.

CANSBE Jr. Local Dues
Follow the link below to complete payment process.

CANSBE Jr. Membership Dues

Receipts will be dispersed upon request.
Should be Empty: