Membership renewal form – Students

First name (mandatory)

Last name (mandatory)

Email (mandatory)

Phone number (mandatory)

Renewal type

Renewal without modification (Move directly to point 2)Renewal with modification (Please specify)

Name of institution

City

Province

Completed studies

Ongoing studies

2. Membership dues and payment methods

The student membership fee is $25 per calendar year and the amount may be paid in two ways:

a) Payment by PayPal: Click on the “Send” button at the bottom of the form and follow the instructions;

b) Payment by cheque: please contact info@acjt.ca for instructions on how to proceed.

I plan to pay by PayPal.I plan to pay by cheque.

3. Signature

I certify that all the information provided on this form is accurate to the best of my knowledge.