QNET Membership
Regional Networks Environment, Health and Safety Knowledge Management Managers Netowrk Healthy Workplace)

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Membership Application Form, Fees and Categories:

* Required information (if not applicable, enter N/A)

Contact Information
Organization name:*
Address:* Street
City
 Province
Postal Code
Web site address:
Contact person: Name*

Position*

 Phone number*

Fax number*

Email address*
Membership Information
Membership category:* (A) For fees, see chart below.


Corporate and Charter members, complete part B.

(B)  List members (include name, title, address, phone number, fax number, and email)
Organization category:*  
(select the most appropriate category)
Number of employees:*  
(number of full time equivalent positions in the organization)
Organization's primary product or service:*

 

Membership Categories and Fees:

Membership Categories

Annual Fee**

 Number of representatives included Fee for each additional representatives** Guidelines (number of employees)
Corporate I
(2 representatives)		 $205 2 $100 1 - 20
Corporate II
(5 representatives)		 $415 5 $80 21 - 100
Corporate III
(10 representatives)		 $615 10 $60 100+
Charter
(11 representatives)		 $2,000 11 $50 any size
Personal*
(1 representatives)		 $135 1 not applicable not applicable

* Note: member rates for personal members are non-transferable.
** Please add G.S.T. to all prices. 

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