CAIP Registration form for Individuals who held designation of the Canadian market research association prior to August 2018 This form is exclusively for prepaid applicants from Leger. CAIP Registration Form form - Leger-Former Designation Name* Prénom Nom de famille Email* Saisissez une adresse courriel Confirmez l’adresse courriel Password* Saisir le mot de passe Confirmer le mot de passe Phone*Job TitleCompany NameAddress Line 1*Address Line 2City*Country*CanadaOtherOther Country*Province*AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonProvince/State/Region*Postal Code / Zip Code*LinkedIn ProfilePreferred Language*EnglishFrenchI agree to have my name listed in the directory of Certified Analytics and Insights Professionals (no contact information will be included)* Yes No I agree to receive emails from CAIP Canada* Yes No Please confirm the following* I held the designation of the Canadian market research association prior to August 2018 I agree to uphold the positive reputation of CAIP Canada and Canada’s research, analytics and insights profession. I will comply with the CRIC standards (ICC/ESOMAR International Code on Market, Opinion and Social Research and Data Analytics) Signature*Ce champ est masqué lorsque l‘on voit le formulaire.CAIP Canada Annual Membership Fee* CAIP Annual Membership ($350) CAIP Annual Membership (10% discount for Membership in CRIC or ESOMAR) ($315) CAIP Annual Membership (20% discount for CRIC and ESOMAR membership) ($280) CAIP Canada Annual Membership (Retired) ($100) CAIP Canada PrePaid or Sponsor Δ