Community Living Peterborough Associate Membership Form
Thank you for choosing to become an Associate Member of Community Living Peterborough. Please fill out this short form.
Yes, I would like to become a 1-year associate member of Community Living Peterborough (complimentary) *
Are you a: Self Advocate Family Member Doctor Professional Business Educator Social Services Agency Other *
Name: *
Address: *
City: *
Province: *
Postal Code: *
Phone Number:
Email: *
Business Name:
Position:
Address:
City:
Province:
Postal Code:
Website:
Please send my Opening Doors Newsletter and eBulletin to this email:
Would you like to learn about becoming a volunteer placement or workplace employer with Community Living Peterborough? No Yes, Please send me more information.
Would you like to display Community Living Peterborough brochures at your place of business? Yes No
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Thank you for your interest in becoming an Associate Member of Community Living Peterborough.
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