Member Application
Canadian Association on Rural and Remote Housing and Homelessness (Formerly the National Coalition on Rural and Remote Housing and Homelessness)
Sign in to Google to save your progress. Learn more
Email *
Organization Name *
Organization Address *
Street address, city, province, postal code
Primary Contact Name *
Primary Contact Email *
Primary Contact Phone Number *
Why are you interested in becoming part of the network and what issues or goals would you like to be addressed?
Would you be interested in becoming an Executive Member?
(responsibilities include, but are not limited to: acting as a provincial liaison, attending regular virtual and face-to-face meetings, producing network content)
Clear selection
If yes, please describe in 50 words or less, why your organization would want to take on this position:
If you have suggestions for any other potential network members, please list them below:
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Rural Development Network. Report Abuse