Membership form

Join the only multisectoral health forum that promotes plural delivery of services, as part of our publicly funded health system.

 

Please complete the form below to confirm your CEPSEM membership for year 7: from February 1st, 2020 to January 31st, 2021


INFORMATION

* Mandatory

AUTOCONTRIBUTION (or based on your organisation's revenue)

* Bronze membership: 1 person per company (any additional attendant pays the non-member fee)
NON-MEMBER : Maximum 2 events per year per company, fee may vary upon event


CONTRIBUTION FOR YEAR 7 : from February 1st 2020 to January 31st 2021


MEMBERSHIP TYPE*:


ENTER YOUR CONTRIBUTION*

+ TPS 5%
+ TVQ 9.9975%

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$CDN

Invoice payable upon receipt. Your invoice will be emailed to you.
Please make your check payable to Conseil des entreprises privées en santé et mieux-être (CEPSEM) Please send it with a copy of the invoice to the following address: 1670, boul. Lionel-Bertrand, Suite 200, Boisbriand (Québec) J7H 1N7.

Tax numbers : TPS : 820017036 RT 0001 / TVQ : 1221010112 TQ 0001


Please indicate if you do not want your company name to appear on the CEPSEM members section on our microsite.