Legal Service Provider Member

APPLICATION FOR MEMBERSHIP – LEGAL SERVICE PROVIDER MEMBERS

THE UNDERSIGNED makes application to the Corporation to become a Legal Service Provider Member of the Corporation, and hereby represents and warrants the following to be true:

I identify as Black or African Canadian;
I am at least eighteen (18) years of age;
I am normally resident in the province of Ontario;
I am a lawyer or paralegal in good standing with the Law Society of Ontario;
I affirm my interest in furthering the Corporation’s purposes; and
I have paid the annual membership dues, that being five dollars ($5), and I understand that such dues will be payable by me each year upon written notice of the board of directors of the Corporation.

Applicant’s contact information:

Printed Name *

Mailing Address *

Telephone Number *

Email Address *