Membership Application

Organization Member Application

Document No.

SSISC-FRM-002

Complete the form below to apply for Organization Membership with SISCC. Your application will be emailed to our membership team and you will be directed to complete your annual membership payment.

Section A

Organization Information

Legal Name of Organization*

Organization Type*

Website

Mailing Address*

City*

Province*

Postal Code*

Organization Phone

Organization Email*

Section B

Primary Contact

Full Name*

Title / Position*

Email Address*

Phone Number

Section C

Organizational Mandate

Describe your organization's mandate:*

How does your organization's work align with SISCC's mission?*

Has your organization previously worked with or supported SISCC?

Yes

Section D

Consent & Signature

I consent to SISCC storing this organization's information for the purpose of membership administration and communication.

I confirm that I am authorized to submit this application on behalf of the organization named above.

Authorized Signatory (Full Name)*

Typing your name constitutes a legal electronic signature.

Date*

Title / Position*

SSISC-FRM-002

Survivors of Saskatchewan Independent Schools Coalition

Both consent statements must be acknowledged before submitting.