Inforoute FPT Membership Application Form

Special Services

Application Form

Inforoute FPT Application Form (2011-2012)

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 = 1 200 $ 5 000 to 9 999 students = 1 550 $ 10 000 to 14 999 students = 2 300 $ 15 000 to 19 999 students = 3 050 $ 20 000 to 24 999 students = 3 800 $ 25 000 to 29 999 students = 4 600 $ 30 000 to 34 999 students = 5 250 $ 35 000 students or more = 5 900 $
Public Private
Public Organizations Public Organizations and Ministries = 1 575$

Please enter your purchase order number for billing purposes Yearly membership from July 1st to June 30th.