Career Trust Service

Member Application Form

To apply, print and complete this form and fax to:
301.907.2864, ATTN: Membership Department

Or, mail to:
AFP of Canada
P.O. Box 7427
Postal Station A
Toronto, ON M5W 3C1

For AFPC Use Only
CT12 ____________
Date ____________
CS Dept _________ 

Please TYPE or PRINT.

Name: ____________________________________________________________

Address: __________________________________________________________

City, Province, Postal Code: ________________________________________________

Phone: _________________________   Fax: ___________________________

E-mail: ____________________________________________________________

Membership ID#:  _______________

Name of most recent employer: ________________________________________

Last date of employment: ____________________________

I AM APPLYING FOR (please check all that apply):

*NOTE:
If a Career Trust member becomes re-employed prior to using the scholarship, its award will be at AFP of Canada's discretion.

Have you ever been an AFP of Canada Volunteer? If so, list all volunteer roles and terms in which you have served. [List on separate sheet(s).]

I affirm that all the information I have stated is true. I understand that membership is conditional upon the qualifications outlined by the Career Trust program. I understand that the information I have listed above is subject to verification by AFP of Canada. If I become re-employed within the calendar year of my dues suspension I agree to remit dues to AFP of Canada for the membership year.

Signature: __________________________________ Date: _______________