* indicates a required field
Name of organization applying for membership*
Name of contact*
first name
last name
Address 1*
Street address, P.O. box, c/o, etc.
Address 2
Suite, building, floor number, etc.
City*
Telephone*
Email*
Type of organization:*
Multi-Employer Benefit Plan
Service Provider
Insurance Company
Other
If a Multi-Employer Benefit Plan, how many members?*
Please select
Under 250 members
250 to 1000 members
Over 1000 members
Name two individuals you want to designate
as MEBCO representatives for your organization:
Check here if one designate is the same as the contact listed above.
Designate 1
first name
last name
Designate 2
first name
last name
Membership fees for the current calendar year:
Funds with less than 250 members
$330
Funds with membership between 250 and 1,000
$660
Funds with over 1,000 members
$1,320
Professional organizations
$550
Make cheques payable to "MEBCO"
Please mail membership fee to:
Multi-Employer Benefit Plan Council of Canada
135 Queen's Plate Drive, Suite 200
Toronto, ON M9W 6V1