Submitted by sgiacomoni on Tue, 2015-01-27 10:17 First Name * Last Name * Member ID Number * Address * Email Address * Telephone * Employer: University/Company * Position Title * Start Date * Year Year20152016201720182019 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Contact Details of Department Head (or verifiable contact) * Link to Online Profile (ex. Listing on University Website, LinkedIn Profile) * Are you a Canadian resident? * Yes, I am currently residing in Canada No, I currently reside outside of Canada CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Math question * 6 + 8 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.