Name of Company

Address

hereby applies for admission as a member of the Central Ontario Industrial Relations Institute, and agrees to pay annual dues, as invoiced.

Name of Primary Contact

Title

Please provide the following Information

Email

Telephone

Nature of Applicants Business

Number of Employees

Name of Union(s) (if any) w/ Expiry Date(s) of Collective Agreement(s) (e.g. CAW, July 99)

Name and Title of Additional Contacts 1) To receive Newsletters Survey Questionnaires (check all that apply) 2) To receive Newsletters Survey Questionnaires (check all that apply)