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Organizational Member

APPLICATION FOR MEMBERSHIP – ORGANIZATIONAL MEMBER

THE UNDERSIGNED, being an authorized representative of

(the “Applicant”), makes application to the Corporation on behalf of the Applicant to become an Organizational Member of the Corporation, and hereby represents and warrants the following to be true:

  • The Applicant is mandated or focussed on delivering services primarily to members of Canada’s Black communities;
  • The Applicant affirms its interest in furthering the Corporation’s purposes;
  • The Applicant has completed the form attached as Schedule A, appointing an Authorized Representative of the Applicant; and
  • The Applicant has paid the annual membership dues, that being twenty-five dollars ($25) and understands that such dues will be payable each year by it upon written notice of the board of directors of the Corporation.

Applicant’s contact information:

per:

I have authority to bind the corporation.


APPOINTMENT OF AUTHORIZED REPRESENTATIVE

THE UNDERSIGNED, being the Organizational Member of the Corporation, hereby appoints

as the Authorized Representative of the Organizational Member, pursuant to section 2.05 of By-Law No. 2018-1.

Authorized Representative’s contact information:

By:

I have authority to bind the entity.