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
 
   
Work Address I'm not working
*Work Address 1
Work Address 2
Work Address 3
*Work City
*Work Province
*Work Postal Code
   
Contact Information  
*Work Phone ( ) -
Work Phone Ext
*Home Phone ( ) -
Mobile Phone ( ) -
Pager ( ) -
Work FAX ( ) -
Home FAX ( ) -
We recommend use of personal email address for privacy reasons
*Work Email
Home Email
*Home Address  
*Home Address 1
Home Address 2
Home Address 3
*Home City
*Home Province
*Home Postal Code
   
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: