Re-enrollment application

Step 3 of 3

Chart for application fees

Subscription Amount fee as of (no taxes are applicable).

Application from the month of:*

September (7 months - $ 116.67)
October (6 months - $ 100.00)
November (5 months - $ 83.34)

Payment choice*

Credit card / Paypal
Interac e-Transfer

Entry into force of the membership status:*

I understand that my membership application will be processed in 1-2 business days, but my membership status will be effective only from the membership month selected above.

Please note that your request will not be processed until we receive your payment.

INTERAC PROCEDURE
To make an Interac transfer, log in to your financial institution's transactional platform and enter the information below:

1. Email: comptabilite@rmpq.ca

2. Amount:Enter the amount for the month of your membership in the chart above.

3. Secret question: * Attention * Enter the full name of the person applying for membership at the location provided for the security question.

4. Answer: rmpq2285

Month of September (7 months)

Price: $ 116.67 CAD

Month of October (6 months)

Price: $ 100.00 CAD

Month of November (5 months)

Price: $ 83.34 CAD

Membership Terms

Professional Covenant
Acknowledgement of the authority of the Disciplinary Committee and the Board of Directors
Limited Consent for Disclosure of Information to Third Parties

I certify that I am 18 years of age or older and that I am the person applying for membership to the Réseau;

I certify that all information provided is true and complete, and I understand that any falsification of information on this application will result in cancellation of my membership and privileges as a member of the Réseau;

I agree to keep my contact information up to date at all times;

I agree to abide by the Réseau's Code of Ethics as well as the general regulations and to any changes thereto that may be brought from time to time;

I acknowledge the authority of the Disciplinary Committee and the Board of Directors with respect to my conduct if I violate any provision of the Code or regulations;

I consent to the provision of a notice to visitors to the Réseau's website, to Réseau Members, to any insurer and any plaintiff, with respect to any penalty that may be imposed on me and the reasons for such a penalty;

These covenants, acknowledgements and consents shall be valid so long as I am a member of the Réseau and therefore apply to any renewal of my membership.

Name*

First Last

Date*

Confirmation*

I acknowledge that I have read the membership terms and accept them.

Re-enrollment application form

Chart for application fees

Membership Terms