2024-2025 Associate Membership Renewal Form | FIANS

2024-2025 Associate Membership Renewal Form

Local *

Valley / South Shore / Central / Highland / Island

Name *

First

Last

Address

Address Line 1

Address Line 2

City

Province

Code Postal

Cell *

Email *

Employer

Employer's Address

Address Line 1

Address Line 2

City

Province

Code Postal

Please indicate here if you agree that we can post your work contact information on the FIANS web site for public viewing. FIANS will not be responsible for any contact initiated by disclosure of this information. *

Yes
No