Exit this survey >> Regular Membership Application Form Question Title * 1. Organization/Company Name Question Title * 2. Primary Contact Name Question Title * 3. Title Question Title * 4. EMail Question Title * 5. Phone Question Title * 6. Mailing Address Question Title * 7. FAX Question Title * 8. Business Type? Type Business Local Government Regional District First Nation Telcommunication Oil & Gas Hydro Transmission or Distribution Rail service Other Business Type menu Other (please specify) Question Title * 9. How did you hear about ICI Society? Question Title * 10. Describe your business (if First Nations please identify the bands represented). Question Title * 11. If your organization is applying as a Utility, to qualify to belong to the Utilities Class an organization must:a) be operating within British Columbia;b) have the purpose of installing and operating physical infrastructure to provide power, telecommunications, rail services or oil and gas gathering, transmission and distribution; and,c) be regulated by any of the following agencies or under any of the following statutes, as amended from time to time:i. BC Utilities Commission;ii. Canadian Radio/Television and Telecommunications Commission;iii. National Energy Board;iv. Innovation, Science and Economic Development Canada;v. Railway Act of British Columbia, as amended from time to time;vi. Railway Act of Canada, as amended from time to time; or,vii. BC Oil and Gas Commission.Please check off all those that apply: be operating within British Columbia have the purpose of installing and operating physical infrastructure to provide power, telecommunications, rail services or oil and gas gathering, transmission and distribution BC Utilities Commission Canadian Radio/Television and Telecommunications Commission National Energy Board Innovation, Science and Economic Development Canada Railway Act of British Columbia Railway Act of Canada BC Oil and Gas Commission Question Title * 12. Fax - if different from above Question Title * 13. How will the ICI Society Member data be used? (Note: Please read the "General Terms and Conditions" and "ICIS Membership Policy") e.g. Will the data support your existing business/datasets? Will it streamline internal business processes? Will it be an additional dataset? Will it allow you to provide additional services? Question Title * 14. Will data be provided externally from your organization to 3rd parties? If so, in what format? ie. map backdrop, hardcopy form, raster information? Question Title * 15. For those members that are planning to access utility datasets, it is required that the data be stored on servers, including backup storage, located within Canada. Are your organization's servers stored in Canada? Yes No Question Title * 16. What areas of the province are of interest to your company ALBERNI CLAYOQUOT RD RURAL BULKLEY NECHAKO RD RURAL CAPITAL RD RURAL CARIBOO RD RURAL CENTRAL COAST RD RURAL CENTRAL KOOTENAY RD RURAL CENTRAL OKANAGAN RD RURAL COLUMBIA SHUSWAP RD RURAL COWICHAN VALLEY RD RURAL EAST KOOTENAY RD RURAL FRASER FORT GEORGE RD RURAL GREATER VANCOUVER RD RURAL ISLANDS TRUST KITIMAT STIKINE RD RURAL KOOTENAY BOUNDARY RD RURAL MOUNT WADDINGTON RD RURAL NANAIMO RD RURAL NORTH OKANAGAN RD RURAL OKANAGAN SIMILKAMEEN RD RURAL PEACE RIVER RD RURAL POWELL RIVER RD RURAL SKEENA QUEEN CHARLOTTE RD RURAL SQUAMISH LILLOOET RD RURAL SUNSHINE COAST RD RURAL THOMPSON NICOLA RD RURAL Comments Question Title * 17. What data does your organization/company own and is willing to share with ICI Society Members? Question Title * 18. Local Government & First Nations membership includes the submission of address information to ICI Society. Do you have address information to contribute? Yes No Question Title * 19. Does your organization need assistance with transforming your addresses into a GIS format? Yes No Question Title * 20. Will there be any restrictions on the data other than those imposed by the DSLA? Question Title * 21. Additional Comments Question Title * 22. Name of Signing Authority Question Title * 23. Title Question Title * 24. Address - if different than above Question Title * 25. EMail - if different from above Question Title * 26. Phone - if different from above Next >>