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Membership Registration
Membership Information
This is the name and information for the company that is registering as a member of CFIA for the current year.
Company Name
*
This is the name that the membership will be recorded under.
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Primary Contact Information
This is the primary point of contact for any questions related to this membership.
Primary Contact Name
*
First Name
Last Name
Primary Contact Email
*
Verify Email
*
Primary Contact Cell Phone
Amount
*
$400
-
Annual Member through December 31 of current year
Add 3% to my total amount to help cover the payment processing fees