edc.membership.form

The member period is from May 1, 2010 to April 30, 2011

The EDC is committed to protecting your privacy; the personal information you are providing
will be used for STLHE membership purposes only.

Section A:

Are you a current STLHE member?
Access Membership Directory

Yes
No

If you answered "No", please complete the STLHE online membership form.

If you answered "Yes", proceed to Section B.

Section B:

Last Name:

First Name:

Primary Occupation:

if Other, please specify

Contact Information:

Institution:

Institution Type:

if Other, please specify

Department:

Address:

City:

Province/State:

Country

Postal/Zip Code:

e.g. A1A 2A2

Business Telephone:

e.g. (xxx) xxx-xxxx

Extension:

Fax:

e.g. (xxx) xxx-xxxx

Email:

This field must be completed for proper acknowledgement.

EDC National Listserv

As an EDC member, your name and email address will automatically be added to the EDC Listserv.
If you do not wish to part of the listserv, please click the box below.

I do not wish to be part of the listserv

Membership Fees: (all prices are listed in Canadian Dollars)

Type	Canada	Outside Canada
Regular Member	$50.00 plus 13% HST	$66.00 plus 13% HST
Retired Member	$25.00 plus 13% HST	$33.00 plus 13% HST
Student Member	$25.00 plus 13% HST	$33.00 plus 13% HST

Payment: STLHE accepts VISA, Mastercard and American Express

Credit Card *

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Note: Once you have completed this form, please click the submit button below. Confirmation of receipt of this form, a printable invoice and mailing instructions will be sent to you by email shortly.