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

Please fill this form out in its entirety.

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

Full Name(Required)

Position(Required)

Phone(Required)

Email(Required)

Full Name

Position

Phone

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.

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