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Associate Membership Application

This firm hereby applies for the Associate Membership in CIFFA, and requests that the persons listed hereafter as its representatives.

If admitted, the firm and its representatives will be governed by the present and future By-Laws of the Association and undertake to pay such fees as may be properly authorized.

You can download and fill out the application below, or fill out and complete the online application form.
 

Required Fields are denoted in red

Company Information
Name of Company:
Type of business:
Head Office
Address 1:
Address 2:
City:
Province:
Postal Code:
Tel: 
Fax:
Website Address:
Email Address:
Branch Offices
No. Of Branch Offices  
Please Enter Branch Office Information

Number of Employees
No. Of Employees:
Information about the applicant company (to determine Class of Membership according to the By-Laws)
President:
Vice-President: 
Secretary:
Treasurer:
Officers for the Company
Official sending in the application:
Title of Official:
Each firm may name two representatives, a designated and an alternate representative.

Representatives can only be changed by a member firm with the approval of the Association.

Designated Firm Representative:
Alternate Representative:
Proposed By CIFFA Regular Member:
Email address:
Seconded By CIFFA Regular Member:
Email address:
CIFFA Member 
Please note that the application for membership must be supported by two current CIFFA Regular members of good standing. The companies names appearing above will be contacted to confirm their support of your application. This application will not be processed or accepted before this confirmation.
Please check off the appropriate Regionall office to which you would like this application to apply to: 
Western Division
- Alberta     - British Columbia
- Northweset Territories
- Nunavut     - Yukon
- Saskatchewan
 
Central Division 
- Kingston, West to the Lakehead
- Manitoba

 
Eastern Division 

- Kingston, East to Newfoundland

Regional Chair Contact Information:

Central Region / Région Du Centre

Eastern Region / Région De L'Est

Ms. Wendy Trudeau, Chair

Tel. (905) 612-7501
Fax. (905) 612-7510
Email: WTrudeau@agilitylogistics.com

Ms. Jennifer Kennedy , Chair

Tel. (514) 633-8026
Fax. (514) 633-5989
E-mail: jennifer.kennedy@sameday.ca

Western Region / Région De L'Ouest

Amy Gumboc, Chair

Tel. (604) 688-8511
Fax. (604) 688-5212
E-mail: amy.gumboc@schenker.ca

Application is incomplete until receipt of cheque. Make cheque payable to CIFFA National, 170 Attwell Drive, Suite 480 , Toronto, Ontario  M9W 5Z5

Effective May 19, 2004
$625.00 + $31.25 for a total of $656.25
Applicant Firm:
Signature of Official:
Date:


  



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