Canadian
New Music Network

Membership form

Service organisation

Contents of the coloured fields will appear on our web site.

First time
Renewal Invoice number (if applicable):

Membership type

Service organisational member (4 votes) $1 per voting member Member count:

CNMN membership is good for one year, from January 1 to December 31.

Preferred Language of Communication

French
English

Verification

This question helps us eliminate spam.

Add 2 and 3

Identity

Official English name of organisation Acronym
Official French name of organisation (if existing) Acronym
Contact first name
Contact last name
Contact title

Contact

Address (no, street, apartment)
City
Province
Country
Postal code
Phone
Main Email address (mandatory field)
Contact phone
Contact email address (mandatory field)
Web site

Description

Please select the category (or categories) — if any — that best describe you. This information will be used for our web directory.

  • Association, organisation
    • Composer or artist association
    • Service organisation
    • Management organisation
    • Educators’ association
    • Author’s rights association

Payment methods

check, money order to CNMN
(Only if you “print” this document to mail to: 416, rue McGill — Montréal QC H2Y 2G1)
VISA
MasterCard
American Express

2-step ordering (easy & secure)

Step 1

Fill-in only the first 8 digits (one per box) of your card.

Cardholder name
VISA, MasterCard or American Express credit card number - - X X X X - X X X X
Expiration date (ex.: 06/14 for June 2014) X X / X X

Note: The merchant name on your credit card statement will be DIFFUSION i MéDIA.

Page caisse@memb_service generated in Montréal by litk 0.600 on Monday, November 7, 2011. Development & maintenance: DIM.

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