Membership Renewal Form - 2011


Renewal Type
Registered Microbiologist (RMCCM) Specialist Microbiology (SCCM) Medical Laboratory Science (SCCM - MLS) Environmental Microbiology (SCCM - ENV) Commercial/Industrial Microbiology (SCCM - IND) Academic and Research Microbiology (ARM) Associate Member (AM) Fellow (FCCM)

Member Type
Regular Member - $110.00 Retired Member - $25.00 AQM and CCM - $135.00

Title

First Name with Initial

Surname


Business Address including Postal/Zip Code

Business Telephone

Business Fax

Business E-mail


Residential Address including Postal/Zip Code

Residential Telephone

Residential Fax

Residential E-mail


Which address would you prefer for CCM correspondence?
Business Residential



Thank you very much for completing our online renewal form.

Use PayPal to renew CCM membership.

Emeritus (retired in any category) : $25.00CAD - yearly Yearly Membership Dues (all categories) : $110.00CAD - yearly

Or send cheque or money order to:


Canadian College of Microbiologists/Collège Canadien des Microbiologistes
356 -1568 Merivale Road
Ottawa, Ontario
Canada  K2G 5Y7

A RECEIPT WILL BE SENT BY E-MAIL OR HARD COPY ONCE PAYMENT IS RECEIVED.