www.Bates.ca

New Associate Information Form

Please complete all fields in the form prior to submission.

Name:
Email:
Fax:
Street Address:
City:
Province / State / Region:
Country:
Postal Code / Zip Code:
Are you currently an independent consultant?	Yes	No
Brief description of your project management experience:
Brief description of your other professional qualifications
Brief description of your potential interest:

Important Notice About Using E-Mail Forms

The information you provide in most e-mail forms (including this one) is not encrypted before being sent to the recipient. Just like sending un-encrypted e-mail from your own computer, this information could possibly be intercepted by a third party. Bates Project Management Inc. will not use any of the information you provide on this form for any purpose other than to respond to your inquiry. Please do not provide any personal information here like your SIN number or a Credit Card number that you would not like freely available on the internet.