Smart Net Coalition Individual Membership

Individual Membership

Smart Net Coalition Individual Membership Application

Please complete the following form to apply to become a Smart Net Coalition Member.

Should you have any questions send an email to info@SmartNetCoalition.ca.

About You
Name*
First Last
Email*
Phone*
Website (if applicable)
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
We here at Smart Net Coalition are working toward the transition to Canada’s Sustainable Economy. This is a vision that has environmental sustainability at it’s core, provides fair and well paying jobs and is connected and community oriented.*
Please describe how you are involved in this transition.
Why would you like to join Smart Net Coalition?*
In a few words, please let us know why membership is important to you...
Online Profiles (if applicable)
LinkedIn
Twitter
The Fine Print
Agreement*
Completion of this application does NOT guarantee Membership in Smart Net Coalition. Your application will be reviewed and you will be notified regarding the outcome of your application.

Also (if applicable), in submitting this application, you agree to the statement, "I have permission from my business/organization to register it for Smart Net Coalition and will be representing my organization and its interests."
- I agree.
Consent*
I consent to be added added to the Smart Net Coalition e-mail distribution list. [We respect your privacy and will never share or sell your information.]
- I agree.
Phone
This field is for validation purposes and should be left unchanged.