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BC Rural Health Network Membership/Renewal Information
Membership – Online Payment for
Cheque Payments please use this form.
Any person, organization or association that support the purpose, principles, and objectives of the BCRHN is eligible to become a Member.
Members are entitled to make motions, vote and/or hold office as Directors, receive minutes of all meetings, and receive written financial statements.
BCRHN Membership Form
Date of Application
(Required)
MM slash DD slash YYYY
Membership Options
(Required)
New Member
Membership Renewal
Membership Category
(Required)
Organization
Individual
Name of Organization or Individual
(Required)
Contact Information
Email
Business Phone
Cell Phone
Other Phone
Street Address
Unit
City
Province/State
Country
Postal/Zip
Organization Information
Names & Titles of Lead Members in Oraganization
(Required)
Please enter one name/title per line.
Organization Overview
Please feel free to input a paragraph or two describing your organization and the services you provide. This will appear on your member page. Thank you
Number of Members in your Organization
Names of Communities Represented by your Organization
Names & Contact Info of your local Newspapers
Please one name/number per line.
Are you willing to volunteer?
Please indicate interest by checking one or more of the following areas of expertise/interest:
Finance
Communications
Promotional
Organizing
Other
Payment Method
(Required)
Please click your payment method below
Credit Card
Interac Direct
After you submit this form you will be redirected to the payment page.
A copy of this form will be emailed to the address you used, please ensure it's correct. Thank you.
