Organization Application

Organization*

Organization Website

Email*

Phone Number*

Street Address*

City*

Province*

Postal Code*

Country*

Did someone refer you to our organization? If so, who?

Each industrial organization, government agency, academic institution, and other incorporated body will be required to designate a formal representative.

Name of designated formal representative*

Title of formal representative*

Direct Phone Number (if different than above)

Email (if different than above)

Organization Logo*

Your organization’s logo will appear on the Nanomedicine Canada member page. File types accepted: jpg, png, eps, pdf and svg.

I certify that all information is true and correct to the best of my knowledge.

Our members are advancing next-generation technologies that are catalysts for change. Together, we’re strengthening Canada’s tech ecosystem, building new opportunities for individuals and industry, and improving lives.

Nanomedicine Canada members must align with the vision and mission of Nanomedicine Canada.Your organization will be notified when the membership decision has been confirmed.

NanoCanada would like to send you announcements and newsletters from time to time. You can unsubscribe if you do not wish to receive them.

For more information contact isabelle.cyr@nanocanada.com

NanoCanada reserves the right to refuse membership and to terminate or suspend membership without prior notice or liability.