Full Name: (required)
Prefered Name: (if any)
Address: (required)
City: (required)
Province: (required)
Postal Code: (required)
Phone Number: (required)
Email: (required)
Occupation / Professional Background : (optional)
Please briefly explain why you are interested in becoming a member of CISOC:
How did you hear about CISOC? (optional)
Please indicate any skills, experience, or interests you would like to contribute:
Approximate time you are willing to contribute:
Please acknowledge each statement:
I support the mission and objectives of CISOC.
I agree to comply with CISOC's bylaws, policies, and code of conduct, as amended from time to time.
I understand that membership is subject to approval by the CISOC Board of Directors.
Do you have any actual or potential conflict of interest that may affect your participation in CISOC?
I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that providing false or misleading information may result in refusal or termination of membership.
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