Member Application form

Membership Form
Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Country
What aspect of development of CCFPJC would you be willing to assist with
Time

Maximum file size: 67.11MB

Membership Fees

ACTIVE CHAPTER Members

FULL Registration Fee: $6,500.00

FULL Renewal Fee: $6,500.00

Discounts may apply based on membership category; please see below

 

ACTIVE DIRECT Members

Registration fee: FULL

Renewal fee: FULL

 

RETIRED and HONORARY Members (must apply directly to CCFP secretariat)

Registration fee: FREE

Renewal fee: FREE

 

ASSOCIATE MEMBERS (must apply directly to CCFP secretariat)

(Interns and Residents in FM program)

4 year limit

Registration fee: FULL

Renewal fee: 50% discount

STUDENT MEMBERS (must apply directly to CCFP secretariat)

(Medical Students)

No automatic renewal; will need to demonstrate student status by mail or email

Registration fee: Free

Renewal fee: Free

SUSTAINING MEMBERS (must apply directly to CCFP secretariat)

Health Professionals allied to Medicine

Registration fee: FULL

Renewal fee: 50% discount

Doctors (Specialists/Consultants) in disciplines other than Family medicine

Registration fee: FULL

Renewal fee: 25% discount

 

CORPORATE MEMBERS

Please contact us

 


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Maximum file size: 67.11MB

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