Organization's address_Adresse de l'organisme

Please enter your organization's information with this survey. At the end of the survey you will have a link to purchase your CAPACOA membership on CAPACOA's website through Paypal.
S.V.P. Inscire les informations au sujet de votre organisme ici. Après le sondage, vous serez transféré vers la page d'achat d'adhésion du site CAPACOA / Paypal.

Organization's name_Nom de l'organisme

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* 1. Organization's name_Nom de l'organisme

Address 1_Adresse 1

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* 2. Address 1_Adresse 1

Address 2_Adresse 2

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* 3. Address 2_Adresse 2

City_Ville

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* 4. City_Ville

Postal code / Zip code_Code postal

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* 6. Postal code / Zip code_Code postal

Website URL_Site web

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* 8. Website URL_Site web

If applicable, please provide your Facebook coordinants_Adresse Facebook

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* 9. If applicable, please provide your Facebook coordinants_Adresse Facebook

If applicable, please provide your Twitter handle (Ex: @CAPACOA)_Identifiant Twitter

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* 10. If applicable, please provide your Twitter handle (Ex: @CAPACOA)_Identifiant Twitter

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