BC Rugby Membership Application

Organization Contact Details

This application is for organizations that want to become a delegate voting member OR affiliate member of BC Rugby.

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* 1. Please enter the following information about your organization:

Full, Legal Name

Mailing Address

Physical Address

Website

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* 2. What type of organization are you registered under?

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* 3. Who is the main contact person at your organization?

Full Name

Position

Phone Number

Email Address

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* 4. Who is the secondary contact person at your organization?

Full Name

Position

Phone Number

Email Address

Please provide a full listing of your organization's Board Members or Officers.

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* 5. Board Member

Full Name

Position

Email Address

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* 6. Board Member

Full Name

Position

Email Address

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* 7. Board Member

Full Name

Position

Email Address

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* 8. Board Member

Full Name

Position

Email Address

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* 9. Board Member

Full Name

Position

Email Address

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* 10. Board Member

Full Name

Position

Email Address

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* 11. Board Member

Full Name

Position

Email Address

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* 12. Board Member

Full Name

Position

Email Address

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* 13. Board Member

Full Name

Position

Email Address

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* 14. Board Member

Full Name

Position

Email Address