SSNM Membership Renewal

Student Membership Form

2019-2020

The Saskatchewan Society of Nutrition Management

P.O. BOX 9685, SASKATOON, SK S7K 7G5

Name *

First Name Last Name

Street address *

Street address line 2

City *

Province *

Postal Code *

Phone Number *

Area Code Phone Number

Email address *

Use personal email-not student email.

Are you currently a CSNM Student Member?

Yes No

If yes, please provide your CSNM Number:

Institution: *

Length of Program *

Ex: 2 years

Anticipate Dates Attended: *

Ex: September 1, 2018 to May 31, 2020

Program Head- Contact Information:

Name *

First Name Last Name

Email *

example@example.com

Phone Number *

Area Code Phone Number

Employer Information:

Business/Organization name

Position or Title

Payment Options & Membership Fees *

PayPal Cheque

**Saskatoon Saskatchewan Polytechnic Students please choose "cheque" option. Do no send a cheque as other arrangements have been made. **

Membership Fee - Cheque

Student Membership $30.00 CAD

**Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card/debit card**

Please make cheque payable to:

Saskatchewan Society of Nutrition Management

Mailing address:

P.O. Box 9685
Saskatoon, SK S7K 7G5

Would you like to opt-in to receive emails (events, promotions, news) from SSNM? *

Yes No

**Reminder: Once you gradutate, you will need to renew your membership on our website using the Membership Renewal Form or by renewing your membership with CSNM (Canadian Society of Nutrition Management) as a dual member*.

*Dual Member: Being an active member with both CSNM and your provincial chapter(SSNM).

Education Information: