CSCB Membership Application

Organization Information

Organization Name

Address 1

Address 2

City

Province

Postal Code

Email Address

Phone

Fax

Website

Applicant Information

First Name

Last Name

Job Title

Email Address

Member Firm Profile

Number of employees at your company

Number of employees engaged in customs brokerage work 50% of the time

Name of Qualified Officer

Date Licence Issued

Year

Month

Day

Branch Locations

Officers and Directors

CSCB Contact Name

Job Title

Email Address

Officer 1 Name

Officer 1 Job Title

Email Address

Officer 2 Name

Officer 2 Job Title

Email Address

Reasons for Joining the CSCB

Agreement to Abide by CSCB Code of Ethics

I, (individual named on customs broker licence)

on behalf of (company name)

acknowledge and agree to operate by the terms of the CSCB Member Code of Ethics.

Dated

Year

Month

Day

Courses

Designations

Events

Join CSCB

CSCB Membership Application

Organization Information

Applicant Information

Member Firm Profile

Officers and Directors

Agreement to Abide by CSCB Code of Ethics

Courses

Designations

Events

Join CSCB