2017-2018 Officials Membership Form

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* 1. Personal Information

First Name *

Last Name *

Address *

City/Town *

Province *

Postal Code *

Date of Birth (YY-MM-DD)

Email Address *

Phone Number *

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* 2. Member Club Affiliation

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* 3. Membership Category

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* 4. Membership Fee

Please submit your payment for the balance due by the registration deadline to ensure your registration is complete.

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* 5. By clicking CONFIRM, I hereby acknowledge that I have fully read the Code of Conduct and recognize that it is intended to uphold the integrity of this organization and its members.

CONFIRM