Individual Member Application

Note: If you are already registered, please log in before completing this application.

Membership Application - Individual

Name

First

Last Name

Last

Date of Birth

Home Address

City

Province

Postal Code

Phone

LinkedIn/Any Other Account Link

Emergency Contact Name

Emergency Contact Phone

Relationship to Emergency Contact

Dropdown

How long have you been in Canada?

Employment Status

Current Profession

Current Educational Institution

(If Student)

What motivates you to become a member of ActionDignity?

0 of 300 max characters

Who referred you to ActionDignity?

Are you interested in joining our Board Committee?

Yes

To complete the application process, please upload your resume/CV below.

CV Upload

Maximum file size: 516MB

If you are a student applicant, please also upload a copy of your student ID below (both sides).

Student ID Upload (If a Student)

Maximum file size: 516MB

If you are human, leave this field blank.