Special Services
Application Form

Inforoute FPT Application Form
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 = 1 015 $
5 000 to 9 999 students = 1 280 $
10 000 to 14 999 students = 1 925 $
15 000 to 19 999 students = 2 575 $
20 000 to 24 999 students = 3 210 $
25 000 to 29 999 students = 3 850 $
30 000 to 34 999 students = 4 500 $
35 000 students or more = 5 140 $
Public
Private
Public Organizations

Public Organizations and Ministries = 1 400$
Please enter your purchase order number for billing purposes

Yearly membership from July 1st to June 30th.