Sign-up to be listed as a champion of responsible energy development in New Brunswick

on the CRED-NB website (www.crednb.ca)

Question Title

* 1. Your name

First name

Family name

Question Title

* 2. Do you wish to be listed as an individual, or your organization, or both?

Individual

Group / organization / business

Both

If you want your organization listed, write the organization here

Question Title

* 3. Location: where do you live? (village/town and province)

Question Title

* 4. Do you agree that CRED-NB can list your name and location on our website? (At any time, you can request to have your name removed)

Yes

No

Question Title

* 5. Your email address (We will send you an email to verify that you agree to list your name on our website)

Question Title

* 6. Would you like to receive a monthly CRED-NB update by email? (At any time, you can request to discontinue the email)

Yes

No

Question Title

* 7. (optional) if you have any comments or questions, leave them here. Thanks!