Inforoute FPT Membership Application Form

Special Services

Application Form

Inforoute FPT Application Form (2009-2010)

Organization's Name	Organization's Website
Region	HTTP Link to Logo
Representative's Last Name	Representative's First Name
Representative's E-mail Address	Representative's Telephone #
Representative's Fax #	Representative's Title
Address
Organization Cégep or college School Board Other	Less than 5 000 students = 1 100 $ 5 000 to 9 999 students = 1 400 $ 10 000 to 14 999 students = 2 100 $ 15 000 to 19 999 students = 2 800 $ 20 000 to 24 999 students = 3 500 $ 25 000 to 29 999 students = 4 200 $ 30 000 to 34 999 students = 4 900 $ 35 000 students or more = 5 600 $
Public Private
Public Organizations Public Organizations and Ministries = 1 500$
Please enter your purchase order number for billing purposes Yearly membership from July 1st to June 30th.