[Cosmetics Correspondence Course]
APPLICATION FOR MEMBERSHIP - 2007 / 2008
(PLEASE PRINT OUT THE FORM (1 PAGE) AND FILL IN THE FIELDS - PLEASE PRINT CLEARLY!)
DATE:__________________________________________________________________
PLEASE CHECK ONE:
[ ] New Member [ ] Renewal [ ] Correspondence Course Graduate [ ] Founder
NAME:________________________________________________________________ [ ]
OCCUPATION / TITLE:___________________________________________________ [ ]
BUSINESS:_____________________________________________________________ [ ]
MAILING ADDRESS: (Is this your home [ ] or business [ ] address?)
STREET:_________________________________________ [ ] APT. # ____________ [ ]
CITY:___________________________________________ [ ] PROVINCE:__________ [ ]
POSTAL CODE:____________ [ ] TEL #:(____)_________________ [ ] EXT:_______ [ ]
FAX: (____)______________ [ ] EMAIL: ____________________________________ [ ]
IN THE INTEREST OF FREEDOM OF INFORMATION, THE CCCA WOULD LIKE TO ENSURE
THAT WE
ARE PUBLISHING ONLY THE INFORMATION THAT YOU WISH TO BE AVAILABLE
TO OUR MEMBERS.
PLEASE CHECK THE BOX AT THE END OF EACH LINE AS TO WHICH
INFORMATION (IF ANY) YOU WOULD LIKE PUBLISHED IN OUR NEXT ROSTER.
IF YOU DO NOT INDICATE WHICH SPECIFIC INFORMATION YOU
WISH TO BE PUBLISHED, WE WILL
DEFAULT TO ALL.
Please forward your membership payment of $25.00 ($15.00 for current students) with this form
to
the CCCA office (or fax if paying by VISA or MasterCard) to the address/fax # below.
[ ] Cheque [ ] Visa Number ______________________________ Expiry date____________
[ ] MasterCard Number ___________________________________ Expiry date__________
Signature__________________________________________________________________
CCCA - Canadian Cosmetics Careers Association
1103 Leslie Street, Suite 101, North York, Ontario,
M3C 4G8, CANADA
When you join the CCCA, you will not receive a Membership card. You will start receiving our Newsletters,
which are published three times a year. You will also be added to our membership Roster, which is
published and mailed out once a year, usually in the Spring. You will also receive any correspondence
by mail such as
notification of our Annual General Meeting and our Award of Merit.
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