Council Member Registration
Local Innovate Council memberhip
Name
*
First Name
Last Name
Which local Innovate Council are you registering to join?
*
Please Select
Calgary Innovate Council
Waterloo Region & Guelph Innovate Council
London Innovate Council
Regina Innovate Council
Windsor-Essex Innovate Council
Winnipeg Region Innovate Council
You will also become a member of the Innovate Council Canada.
Name of your organization?
*
Gov't agency, Company, or Community organization
Current job title (or role) within your organization?
*
If appropriate, which department are you employed?
Select the type of organization you are with:
*
Public Sector (or publicly funded organization)
Private Sector
Other (example: Non-profit organization)
Individual (community member, not associated with any organization)
If you are with the public sector, which level of government organization?
Municipal/Regional/County
Indigenous
Provincial
Federal
Other
Your Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
LinkedIn Profile?
*
Your name/image on the Innovate Council Canada site will be directed to your LinkedIn profile
Your Work Mailing Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Submit
Should be Empty: