Supply Chain Canada Student Affiliate Registration

Supply Chain Canada - Student Affiliate Application - Step 1/2

	$29.00	Student Affiliate
	This is a non-voting membership available for full-time university/college students. Membership expires on March 31st each year.

Salutation:

First name*:

Middle initial:

Last name*:

Primary email*:

Alternate email:

Phone (xxx-xxx-xxxx):

ext

Alternate phone:

ext

Mobile Phone:

Post-Secondary Institution*:

Program*:

Year expected to complete program*:

Preferred language:

Press "Continue" to proceed to the next step.