Please note that the below form is for new Perkopolis partners only. If you or your organization is already part of Perkopolis, please contact our customer service for support. 

First Name

Last Name

Email

Job Title

Phone Number

Association Name

Association Website (URL required)

Number of Association Employees

Number of Members

Please select which of the below are applicable for your membership eligibility and registration Payment of a membership feeVerification of professional credentials or accreditation (e.g. license, certification, governing body registration)Verification of employment, affiliation, or eligibility criteria (e.g. role, industry, employer, or demographic criteria)Application review and approval by an administrator (i.e. Memberships / IDs are not generated and issued automatically)Student memberships are availableMembership is open with no formal eligibility checks

If applicable, provide the web URL for your online application/form

Where in Canada do you plan to make this program available? (select all that apply) Canada WideAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundlandNorthwest TerritoriesNunavutNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewanYukon

Preferred Communication Language anglais / English français / French

Industry Manufacturing Accommodation and Food Services Administrative and Support and Waste Management and Remediation Services Agriculture, Forestry, Fishing and Hunting Arts, Entertainment, and Recreation Educational Services Finance and Insurance Health Care and Social Assistance Information Management of Companies and Enterprises Mining, Quarrying, and Oil and Gas Extraction Nonclassifiable Establishments Non-Employer Other Services (except Public Administration) Professional, Scientific, and Technical Services Public Administration Real Estate and Rental and Leasing Retail Trade Transportation and Warehousing Wholesale Trade Construction Utilities

How did you learn of Perkopolis? Referral CPHR Previously used Perkopolis Independent research Social Media Perkspot referral

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