2025 Affiliate Registration Form - First Call Child and Youth Advocacy Society

Please fill this form out in its entirety.

Your Organization's Contact Information

Are you applying as a New Affiliate member or Renewing your membership?(Required)

Organization's Legal Name(Required)

Abbreviation (if any)

Address(Required)

Street Address Address Line 2 City Postal Code

Approx. Number of Employees(Required)

Please enter a number greater than or equal to 0.

Website

Main Contact

Full Name(Required)

Position(Required)

Phone(Required)

Email(Required)

Alternative Contact (Optional)

Full Name

Position

Phone

Commitment as a First Call Affiliate

Signing Options(Required)

Upload Signature

Sign/Mark With Mouse/Finger

File(Required)

Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB.

Signature(Required)

I am the authorized representative and signatory for this organization:

Print Full Name of Signee(Required)

Any Additional Information

You can mention any additional information you’d like us to know here.

How Do You Want to Pay(Required)

Credit Card – First Call’s Online Payment Form

Bank Account – First Call’s Online Payment Form

E-Transfer

Cheque by Mail

Other

After submitting this form, you will be redirected to the “Affiliate Membership Payment” page.

Name

This field is for validation purposes and should be left unchanged.

SUPPORT OUR 2025 30 FOR 30 CAMPAIGN

This Holiday Season,Your Gift Will Be MATCHED!

Your Gift Can Make 2X The Difference for BC's Kids

Your Organization's Contact Information

Main Contact

Alternative Contact (Optional)

Commitment as a First Call Affiliate

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SUPPORT OUR 2025
30 FOR 30 CAMPAIGN

This Holiday Season,
Your Gift Will Be MATCHED!