BPW Interest and Membership Form

I am ...(Required)

Club(Required)

Geographically closest to you

Please give us some Information on where you are located to help us determine which club to direct you to.

This field is hidden when viewing the form

Ontario Province

This field is hidden when viewing the form

Alberta Province

This field is hidden when viewing the form

Saskatchewan Province

This field is hidden when viewing the form

New Brunswick Province

This field is hidden when viewing the form

Quebec Province

Name(Required)

First Last

Email(Required)

Email to be used for BPW Mailings

My primary language is(Required)

How did you hear about BPW?(Required)

Contact Information

Address(Required)

Street Address City Province / Territory Postal Code

Contact Phone Number(Required)

Occupation/Profession/Education

Are you employed?(Required)

Yes

Are you self employed?(Required)

Yes

Occupation/Business Information(Required)

Are you a Student (60% or more of full time studies)?(Required)

Yes

Are you 35 years old or younger (Young BPW)?(Required)

Yes

Knowledge of BPW and Interests

How did you hear about BPW?(Required)

Do you know anything about BPW?

Yes

What are you looking for from BPW (Learn, Advocate, Lead, Collaborate)?

BPW's Four Cornerstones - BPW Canada (click to visit web page)

Do you have some preliminary questions?

What skills or knowledge would you like to share with BPW (Management, Finance, Communications, Business, Fundraising, Other)?

Renewing

Special Member Categories

Please select any that apply

Member - Young BPW (35 years old or younger)

Member - Student (60% or more of full time studies)

Member - Life

Has any of your address information changed?

Please click Yes for completion up to March 31, 2026

Yes

Please fill in the changes to your address(Required)

Street Address City Province / Territory Postal Code

Has any of your Occupation/Business Information changed?(Required)

Please click Yes for completion up to March 31, 2026

Yes

Please provide your updated Occupation/Business Information

Contact Information Changes

I am a member of BPW and have the following changes to be made to my:

Updated Address

Street Address City Province / Territory Postal Code

Contact Phone Number

Email Address

Occupation/Profession

Other (Resigning, Deceased, other information)

Interests

What areas of BPW interest you this year (Learn, Advocate, Lead, Collaborate)?

BPW's Four Cornerstones - BPW Canada (click to visit web page)

What skills or knowledge would you like to share with BPW (Management, Finance, Communications, Business, Fundraising, Other)?

Consent (Required)

Consent Items(Required)

I hereby give consent for BPW to use my personal information on this application and/or use and distribute my image or voice in photographs or video for the sole purpose of providing benefits of membership (i.e. Newsletters, Annual Reports, Web Site, Social Media as appropriate) within the different levels of the BPW organization (BPW , BPW Canada, BPW International).

I further, agree to protect members' personal information from distribution, publication or any commercial use whatsoever.

I hereby give consent for my personal information to be distributed to other members on the BPW membership roster as described above.

I hereby give consent for BPW and BPW Canada to email communications to me. You can revoke permission to mail to your email address at any time by using the Safe Unsubscribe link found at the bottom of every email.

I do NOT give consent to BPW to share my information in any manner. (If you tick this box you will not receive communications from any level of BPW).

Consent (Required)

Consent Items(Required)

I further, agree to protect members' personal information from distribution, publication or any commercial use whatsoever.

I hereby give consent for my personal information to be distributed to other members on the BPW membership roster as described above.

This confirms your renewal of membership information and is a reminder to remit payment of membership fees as requested by your club.

I do NOT give consent to BPW to share my information in any manner. (If you tick this box you will not receive communications from any level of BPW).

Consent (Required)

Interest Consent Items(Required)

This field is hidden when viewing the form

Mailing List