Join the only multisectoral health forum that promotes plural delivery of services, as part of our publicly funded health system.
* Mandatory
COMPANY NAME*
NAME OF REPRESENTATIVE *
TITLE *
EMAIL *
TELEPHONE*
COMPANY ADDRESS*
SUITE
CITY*
PROVINCE*
POSTAL CODE*
MEMBERSHIP TYPE*: Please choosePLATINUMGOLDSILVERBRONZEASSOCIATE
ENTER YOUR CONTRIBUTION* + TPS 5% + TVQ 9.9975% =======
TOTAL : $CDN
Invoice payable upon receipt. Your invoice will be emailed to you.
Please indicate if you do not want your company name to appear on the CEPSEM members section on our website.
