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M
embership
A
pplication
F
orm
Charter membership ($10,000 Cdn one-time fee)
Associate membership ($2,500 Cdn one-time fee)
Individual membership (no fee)
I am interested in receiving P³G emails and other correspondence.
My contact information is
:
First Name:
Last Name:
Affiliation (company/institution/other):
Address:
Business telephone:
e-mail:
Short description of your affiliation/areas of population-based research (100 words or less):
Short description of your project:
Please attach your curriculum vitae:
OR
For more information regarding the application procedure, please contact
Denis Legault
Executive Director
P3G Consortium
3333 Queen Mary Road
Suite 590
Montreal, Quebec
H3V 1A2
Tel: +1 (514) 343-7001 ext 4907
Fax: +1 (514) 343-2270
Email:
dlegault@p3g.org
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