Student member application form

Step 1 of 2
To become a student member, you have to fulfil the file opening application below or download the printable version and send it back to the Réseau by mail or fax.
Correspondence language:*
- French
- English
Gender:*
- Mrs.
- Mr.
Name*
First Last
Date of birth:*
Example of a properly written address: 23-2285, rue Saint-Pierre, Drummondville, Quebec J2C 5A7
Address:*
Civic number, Street, Apartment number City Province Postal code
Select your area:*
Address confirmation*
- I confirm that the address above is complete and includes my apartment or rental space number if applicable.
Phone*
Cell phone
Email (required)*
Academic institutions*
Other, specify

Step 2 of 2
Please attach a COMPLETE copy, INCLUDING the signature of the representative of the contract established with the academic institution.*
Accepted file types: jpeg, jpg, pdf, png, gif, docx, doc, Max. file size: 25 MB.
Proof of identity ( (example: driver’s license, health insurance card, and/or passport)*
Accepted file types: jpeg, jpg, pdf, png, gif, docx, doc, Max. file size: 25 MB.
Professional commitment

Special instructions regarding student membership

A student membership means anyone studying in a discipline accredited by the Réseau and who meets the criteria as defined by the board and the admission requirements of these regulations.

It is important to note that the student member does not have the ability to: • purchase of any equipment or material of the shop of the association; • provide receipts for insurance reimbursement; • benefit from any form of recognition; • vote at meetings of members or to be a director.

Student member also agrees to comply with the Code of Ethics and general regulations available on the website of the Réseau and is subject to sanctions for non-compliance.

I hereby, certify that I am 18 years old and over and I am the person applying for this membership to the Réseau and that all statements are true and complete. I understand that any falsification of information on this application will result in a cancellation of membership and privileges as a professional member.
Name*
First Last
Date
DD slash MM slash YYYY
Allow 1-2 business days for:

1. Analysis of your file

2. Obtaining your membership number by e-mail

Step 1 of 2

Step 2 of 2