User Registration Form (Organization) HiddenAccount Type(Required) Organization Username(Required)Enter a username that will be used when logging in. This cannot be changed. Password(Required) Enter Password Confirm Password Strength indicator OrganizationOrganization or Group Name(Required) Organization or Group Type(Required)Japanese CanadianNon-Japanese CanadianWe are a not for profit corporation incorporated federally or provincially in Canada Yes No What is the main purpose of your organization?(Required)Please describe your organization's connection to the Japanese Canadian community in 300 words or less(Required)Organization Email Address(Required) Organization Phone Number(Required)Organization Alternate Phone NumberOrganization Website Organization Social Media Address Organization Address(Required) Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Primary Contact InformationPrimary Contact Name(Required) First Middle Last Primary Contact Position/role in the group or organization(Required) Primary Contact E-mail Address(Required) Primary Contact Phone Number(Required)Primary Contact Alternate Phone NumberAttestation(Required) By completing this registration form I declare that the information above is truthful and accurate to the best of my knowledge and belief.CAPTCHA
