HD Test - Canoe Procurement Group of Canada

Canoe Membership Form

Billing Information

Organization Name(Required)

Organization Type(Required)

City(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Accounts Payable Email (for invoices and statements)(Required)

Accounts Payable Phone(Required)

Billing Contact Name(Required)

First Last

Position(Required)

Email(Required)

Phone(Required)

Consent(Required)

I agree that the organization I represent will pay invoices for products and services purchased through Canoe programs.

Primary Shipping Information

Shipping

My organization’s primary shipping address is the same as my organization’s billing address

Description

(example, Public Works Facility, Branch, etc)

City

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shipping Contact Name

First Last

Position

Email

Phone

To add additional shipping locations, please fill out and submit the Additional Shipping Locations Form.

News

I would like to sign up for news about Canoe offerings and events.

Terms & Conditions

I agree to Canoe’s terms and conditions.

By default, your organization will be signed up to be able to procure through all of Canoe’s programs. To opt out of eligibility for specific programs, please complete and submit the program opt-out form.

Additional Shipping Locations

Additional Shipping Location Information

Organization

Description

(e.g. Public Works Facility, Branch, etc.)

City

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shipping Contact

Name

First Last

Position

Email

Phone

Program Opt-Out

Organization Name

Please remove the following programs from my organization:

Name

First Last

Email

Phone

Canoe Membership Form

Billing Information

Primary Shipping Information

Additional Shipping Locations

Additional Shipping Location Information

Shipping Contact

Program Opt-Out

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