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Listed Company Information
(complete this section only if you are employed at a company whose securities are listed for trading)

Industry Sector

• None
• Agriculture
• Biotechnology and Pharmaceuticals
• Communications and Media
• Conglomerates
• Consumer Products (Food Processing, Tobacco, Distilleries, Breweries, Beverages, Household Goods, Auto/Parts, Packaging)
• Diversified Industries
• Financial Services (Banks, Trust, Savings & Loan, Investment Companies & Funds, Insurance, Financial Management Companies)
• Hospitality & Entertainment
• Industrial Products (Steel, Fabricating, Engineering, Transportation Equipment, Technology, Computer, Cement/Concrete Products, Chemicals, Business Services)
• Manufacturing
• Health Care
• Merchandising (Wholesale Distributors, Food and Merchandise Stores, Hospitality)
• Mining (Base and Precious Metals)
• Energy
• Paper & Forest Products
• Real Estate and Construction
• Technology
• Transportation and Environmental Services
• Utilities and pipelines
• Waste Management
• Other
• Clean Technology

Market Capitalization

None
$0 - $25 million (small cap)
$26 - $99 million (small cap)
$100 - $999 million (mid cap)
$1 billion or greater (large cap)

Membership Category Selection (all applicants to complete)

Regular Member (listed company employee)
Associate Member (typically some kind of service provider)
Consultant

How did you hear of CIRI?

• Website
• Printed Material
• Attended CIRI Event
• Referral from (name)
• Other

Dues Selection

Dues* including chapter fee $740.00
(Plus applicable taxes)

• Alberta Chapter
• British Columbia Chapter
• Ontario Chapter
• Quebec Chapter

*includes application administrative fee of $75. GST Registration 86743185ORT

By submitting this membership application CIRI, the applicant agrees to abide by CIRI's bylaws.

I consent to the collection, use and disclosure of my personal information during the course of my membership for the purposes set out in the CIRI members' Privacy Policy, which is available on www.ciri.org. I further consent to my contact information being published in web or print directories produced by CIRI and/or its chapters.

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