OAR - CME

Purchase Membership

OAR Membership Registration

Please fill out this registration form and your credit card information.

Click here to read the benefits of being an OAR member.

OAR Annual Membership Fee: $2500.00 (CAD)

Membership fee will be charged to your credit card.

*Username
*Password
*Confirm Password

*CPSO #

Title
*First Name
*Last Name
*Personal Email
*Work Email

Work Address	I'm not working
*Work Address 1
Work Address 2
Work Address 3
*Work City
*Work Province
*Work Postal Code

*Home Address
*Home Address 1
Home Address 2
Home Address 3
*Home City
*Home Province
*Home Postal Code

Contact Information
*Mobile Phone	( ) -
Work Phone	( ) -
Work Phone Ext

Billing Address
*Name
*Email Address
*Phone Number
*Address
Address 2
*City
*Province
*Postal Code
Country

CC Information

*CC number
*CCV
*Name on Card
*Expiry Date	Month: / Year: