• General Information

  • Please note that all membership applications are subject to approval by LTCAM. Payment should not be submitted until an invoice has been issued. All membership fees are subject to GST.

  • Format: (000) 000-0000.
  • Billing address(If different)*
  • Active in Manitoba*

  • Engagement and Priorities

  • Please select what you hope to gain from membership.*
  • Please select activities of interest*
  • How did you hear about LTCAM*

  • Membership Categories

    Please review and select all that apply.
  • Select all membership categories that apply*

  • Care and Housing Providers

  • Ownership Group

    Refers to one legal entity that owns and operates multiple long-term care facilities, short-term care facilities, and/or older adult housing complexes.

  • Are you registering as an Ownership Group or Individual Facility?*

  • Professional Affiliates

    Please click the arrow to expand your desired section
    • Academic or Research Institution 
    • Do you provide Training, Certification, or research services in the long term and continuing care sector?*
    • Do you currently provide services/training in Manitoba?*
    • Are you interested in collaborative research or pilot projects?*
    • Union 
    • Professional Associations 
    • Do you directly support individuals working in care, housing, or wellness roles for older adults?*
    • Does your organization provide continuing education, certification, or standards of practice for professionals in these fields?*
    • Are you incorporated as a professional association, society, or college under provincial/federal legislation?*
    • Do you have bylaws, a board of directors, and a defined membership structure?*
    • END 

  • Charitable and Not for Profit Organizations Serving Older Adults

  • Are you a registered Charity?*

  • Community Partners

  • Please Select*
  • Do you have existing partnership with long-term care facilities or housing providers?*

  • Private Home Care & Staffing Agencies

  • Select all that apply*
  • Do you operate on a fee-for-service basis*

  • Business Partners

  • Have you sponsored of exhibited at a prior LTCAM event?*
  • Are you registered with the Better Business Bureau of Canada?*

  • Contact and Accounting

    • Main Contact 
    • Format: (000) 000-0000.
    • Accounting Contact 
    • Format: (000) 000-0000.
    • END 

  • Agreement

  • I agree to receive electronic communications from the Long Term and Continuing Care Association of Manitoba.*
  • Should be Empty: