WISE NL Corporate Membership
Application or Renewal Form

Corporate Member rate is $300 per year.
Corporate Member fee is due not later than December 31.
- Fees received between September 1 and December 31 shall be credited to the following year.
- Fees received between January 1 and August 31 shall be credited to the current year.
To save costs, we do not accept credit card payments. We request that you e-transfer payment to treasurer@wisenl.ca.
If you wish to pay by cheque, do not used this form. Please submit a paper application and indicate if you require an invoice.

Contact Information (*=Required)
*Company Name:
*Company Website:
*Primary Contact:
*Primary Contact Email:
*Primary Contact Phone:

Is this a new membership or a renewal?

Are you interested information on sponsorship opportunities?

Declarations (Required)
YesNo	Our organization, and by extension those named below, understand and support the objectives of WISE NL.
YesNo	In accordance with the Canadian Ant-Spam Legislation (CASL), the following individuals grant permission to include their email address in the WISE NL email distribution list

Designated Members (*=Required)

*Name 1:
*Email 1:		Phone 1:

Name 2:
Email 2:		Phone 2:

Name 3:
Email 3:		Phone 3:

Name 4:
Email 4:		Phone 4:

Name 5:
Email 5:		Phone 5:

Notifications

By submitting this form, you're granting WISE NL (PO Box 23176, Churchill Square, St. John's, NL A1B 4J9, Canada) permission to email you. You can revoke permission to mail to your email address at any time using the SafeUnsubscribeTM, found at the bottom of every email.
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Please note: Your membership is not consider complete until payment of membership fees is received.