Media Association Listing Application Form

You may apply online here or download the pdf application form to send to CARDonline.

Fill out the general information form below. When complete, click SEND APPLICATION TO CARD.

Where information is not available, indicate with 'n/a'.

* indicates required field

GENERAL INFORMATION

Association Name: *
Address: *
City: *
Province/State: *
Postal Zip/Code: *
Country:
Phone: *
Toll Free:
Fax: *
Email: *
Website: *

Does your website offer advertising space? Yes No

If yes, you also qualify for a free listing in the Online Advertising Services section. Please complete and submit the application form for your website listing by clicking on the 'Online' tile to the left of this screen.

CONTACT INFORMATION

You will be receiving an update of your information on a monthly basis. To whose attention should these updates be sent?

First name: *
Last name: *
Title: *
E-mail: *
To which address? (if different from address above)
Company:
Address:
City:
Province/State:
Country:
Postal/Zip Code:

ASSOCIATION INFORMATION

Give a brief description of the association’s profile. Refrain from using any branding phrases eg. largest association in Canada, etc.:

EXECUTIVE PERSONNEL

List the names and titles of the association's executive body and board of directors; if not employed full-time by the association, list their full-time employer.

Name:
Title:		Employer:

Name:
Title:		Employer:

Name:
Title:		Employer:

Name:
Title:		Employer:

Name:
Title:		Employer:

Name:
Title:		Employer:

Name:
Title:		Employer:

Name:
Title:		Employer:

I understand that CARDonline has the right to edit any and all information as supplied by the listee or on the listee's behalf. I further understand that all information regarding this listing is the exclusive property of CARDonline and may be stored, published and sold at the discretion of CARDonline and likewise may be modified, appended or deleted at any time in accordance with current editorial policies. Moreover, I agree to update this listing on a monthly basis or as requested by CARDonline.

I accept – Name: Date: Format: mm/dd/yy

I decline