***Please PRINT all Information***
Annual TCA Application Form
INSTALLATION:
| COMPANY: ______________________________________________ |
| DEPARTMENT: ___________________________________________ |
| STREET: _________________________________________________ |
| CITY: ___________________________________________________ |
| POSTAL CODE: _____ _____ |
KEY CONTACT:
| NAME: __________________________________________________ |
| PHONE NUMBER: _________________________________________ |
EXT: _____ |
| FAX NUMBER: ___________________________________________ |
EXT: _____ |
| E-MAIL ADDRESS: _______________________________________ |
SECOND CONTACT
| NAME: __________________________________________________ |
| PHONE NUMBER: _________________________________________ |
EXT: _____ |
| FAX NUMBER: ___________________________________________ |
EXT: _____ |
| E-MAIL ADDRESS: _______________________________________ |
THIRD CONTACT
| NAME: __________________________________________________ |
| PHONE NUMBER: _________________________________________ |
EXT: _____
|
| FAX NUMBER: ___________________________________________ |
EXT: _____ |
| E-MAIL ADDRESS: _______________________________________ |
FOURTH CONTACT
| NAME: __________________________________________________ |
| PHONE NUMBER: _________________________________________ |
EXT: _____
|
| FAX NUMBER: ___________________________________________ |
EXT: _____ |
| E-MAIL ADDRESS: _______________________________________ |
TCA information and meeting notices will be sent out via e-mail or provided on our website at www.torontocics.org.
Enclosed TCA membership fee (Please circle one)
Individual............$100.00 Corporate (4 people)............$300.00
Please print out this application form and make cheque payable to: Toronto CICS Association, and return it with the application form to :
Attn: Treasurer
Toronto CICS Association
Box 956, Adelaide Street Post Office
Toronto, Ontario
M5C 2K3
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