Membership renewal form

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)

1. Information

Name of employer

Position

Professional address

City

Province

Area of expertise

Source language

Target language

Professional affiliations

Degrees obtained

2. Publication authorization

I consent to ACJT-CALT publishing my contact information in the members’ directory on its website: www.acjt.caI do not consent to ACJT-CALT publishing my contact information in the members’ directory on its website: www.acjt.ca

3. Membership dues and payment methods

Membership dues are $100 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.

4. Signature

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