Partners Application

Name*

First Last

Job Title*

Email*

Enter Email Confirm Email

Organization*

Website

Organization Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please provide a brief description about your organization*

What best describes your organization?*

University/College/School
Training Firm
Training Department
Government Agency
Professional Association
Non-For-Profit Organization

How do you deliver your educational services?*

Tranditional Classroom
e-Learning
Conferences

In what languages do you provide your educational services?*

English
French
Spanish
Arabic
Chinese
Russian
Others

What are the other certification courses you offer?*

Upload ONE governmental-issued identification to show a company registration

Valid ID is any of the following: - Business Registration - Article of Incorporation - Trade License All documents must be valid. If upload doesn't work, please send the document to Hello@CCLMCanada.org

Agreement*

Please read and confirm the Registered Partner Agreement

Provide your Electronic Signature*

A valid electronic signature must look like this: // FirstName LastName// Or // LastName FirstName//

Billing Address*

Same as previous

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Country*