Professional Member Registration

Branch *

Salutation *

First Name *

Last Name *

Date of Birth

Primary Phone Number *

Secondary Phone

Primary Email*

Secondary Email

Position *

Home Address

Address line 1 *

Address line 2

City *

Province *

Postal Code *

Country *

Work Address

Name of Organization *

Existing Office

Create New Office

Website *

Ownership *

Organization Type *

Telephone

Fax

Address Line 1 *

Address Line 2

City *

Province *

Postal Code *

Country *

Please send correspondence to my *

Work

Home

Spouse / Partner Information

Salutation

First Name

Last Name

Secondary Email

Do you consent to have your information displayed in the CMAC online directory? *

CMAC produces a real-time directory for members. You may customize your communication preferences at any time by accessing your profile.

Yes, display my name and primary contact information.

Yes, display my name and company only.

No, do not display my information.

Were you previously a member of CSCM? If so, which year(s)?

Password must be a minimum of 8 characters long and contain at least 1 uppercase letter, 1 lowercase letter and 1 number.

Password

Confirm password

By submitting this registration form, I agree to abide by CMAC’s Code of Ethics.