Test Form

HomeTest Form

General Information

Payment can be made by PayPal, Visa, MasterCard or American Express through the PayPal site.

Are you a new member, or a renewing member?

What is your name?

How many people are you registering for?

Are you paying on behalf of yourself, another Individual, Group/Organization?

What is the name of your organization?

Please provide the first 3 digits of your postal code or the postal code for your organization:

(All payments are made through the PayPal site. Payments can be made by PayPal, or if you would like to pay through Visa, MasterCard or American Express scroll down. A PayPal account is not necessary.)

Person Filling Out The Application

Please use the same email address on the PayPal payment site as well.

Name Email Telephone

Group/Organization Members

(If you are part of the group/organization, please include your preferred email)

Name Email Telephone

For larger groups, please upload a separate document with all names and contact information, preferably in Microsoft Word format.

We communicate mostly through email. Please provide accurate email addresses and notify the membership secretary of any changes at

The Provincial Authority for The Baby-Friendly Initiative

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