Membership Form

All prospective members of CPFA are required to complete this registration form in its entirety. CPFA members will be able to participate in activities and general meetings. CPFA will welcome any suggestions given by members into consideration. Members will also receive newsletters to inform of the activities and progress of the community. The information provided below will also be used to keep you informed about CPFA events in the future. Please let us know if you intend to volunteer your services in any capacity.

To become the member has two steps, first fill out the below form completely and in the bottom click the subscribe button, second you will receive a confirmation email in your email box, please click the confirm button and it will register you as a member.

<!-- Begin MailChimp Signup Form --> <link href="//cdn-images.mailchimp.com/embedcode/classic-10_7.css" rel="stylesheet" type="text/css"> <style type="text/css"> #mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; } /* Add your own MailChimp form style overrides in your site stylesheet or in this style block. We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. */ </style> <div id="mc_embed_signup"> <form action="//cpfacanada.us14.list-manage.com/subscribe/post?u=026a5026af6a51f971be81150&id=c8aa191a78" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate> <div id="mc_embed_signup_scroll"> <div class="indicates-required"><span class="asterisk">*</span> indicates required</div> <div class="mc-field-group"> <label for="mce-EMAIL">Email Address <span class="asterisk">*</span> </label> <input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL"> </div> <div class="mc-field-group"> <label for="mce-FNAME">First Name <span class="asterisk">*</span> </label> <input type="text" value="" name="FNAME" class="required" id="mce-FNAME"> </div> <div class="mc-field-group"> <label for="mce-LNAME">Last Name <span class="asterisk">*</span> </label> <input type="text" value="" name="LNAME" class="required" id="mce-LNAME"> </div> <div class="mc-field-group size1of2"> <label for="mce-MMERGE3">Phone Number <span class="asterisk">*</span> </label> <div class="phonefield phonefield-us"> (<span class="phonearea"><input class="phonepart required" pattern="[0-9]*" id="mce-MMERGE3-area" name="MMERGE3[area]" maxlength="3" size="3" value="" type="text"></span>) <span class="phonedetail1"><input class="phonepart required" pattern="[0-9]*" id="mce-MMERGE3-detail1" name="MMERGE3[detail1]" maxlength="3" size="3" value="" type="text"></span> - <span class="phonedetail2"><input class="phonepart required" pattern="[0-9]*" id="mce-MMERGE3-detail2" name="MMERGE3[detail2]" maxlength="4" size="4" value="" type="text"></span> <span class="small-meta nowrap">(###) ###-####</span> </div> </div><div class="mc-address-group"> <div class="mc-field-group"> <label for="mce-MMERGE4-addr1">Address <span class="asterisk">*</span> </label> <input type="text" value="" maxlength="70" name="MMERGE4[addr1]" id="mce-MMERGE4-addr1" class="required"> </div> <div class="mc-field-group"> <label for="mce-MMERGE4-addr2">Address Line 2</label> <input type="text" value="" maxlength="70" name="MMERGE4[addr2]" id="mce-MMERGE4-addr2"> </div> <div class="mc-field-group size1of2"> <label for="mce-MMERGE4-city">City</label> <input type="text" value="" maxlength="40" name="MMERGE4[city]" id="mce-MMERGE4-city" class="required"> </div> <div class="mc-field-group size1of2"> <label for="mce-MMERGE4-state">State/Province/Region</label> <input type="text" value="" maxlength="20" name="MMERGE4[state]" id="mce-MMERGE4-state" class="required"> </div> <div class="mc-field-group size1of2"> <label for="mce-MMERGE4-zip">Postal / Zip Code</label> <input type="text" value="" maxlength="10" name="MMERGE4[zip]" id="mce-MMERGE4-zip" class="required"> </div> <div class="mc-field-group size1of2"> <label for="mce-MMERGE4-country">Country</label> <select name="MMERGE4[country]" id="mce-MMERGE4-country" class="required"><option value="">Select a country</option><option value="164">USA</option><option value="286">Aaland Islands</option><option value="274">Afghanistan</option><option value="2">Albania</option><option value="3">Algeria</option><option value="178">American Samoa</option><option value="4">Andorra</option><option value="5">Angola</option><option value="176">Anguilla</option><option value="175">Antigua And Barbuda</option><option value="6">Argentina</option><option value="7">Armenia</option><option value="179">Aruba</option><option value="8">Australia</option><option value="9">Austria</option><option value="10">Azerbaijan</option><option value="11">Bahamas</option><option value="12">Bahrain</option><option value="13">Bangladesh</option><option value="14">Barbados</option><option value="15">Belarus</option><option value="16">Belgium</option><option value="17">Belize</option><option value="18">Benin</option><option value="19">Bermuda</option><option value="20">Bhutan</option><option value="21">Bolivia</option><option value="22">Bosnia and Herzegovina</option><option value="23">Botswana</option><option value="181">Bouvet Island</option><option value="24">Brazil</option><option value="180">Brunei Darussalam</option><option value="25">Bulgaria</option><option value="26">Burkina Faso</option><option value="27">Burundi</option><option value="28">Cambodia</option><option value="29">Cameroon</option><option value="30" selected>Canada</option><option value="31">Cape Verde</option><option value="32">Cayman Islands</option><option value="33">Central African Republic</option><option value="34">Chad</option><option value="35">Chile</option><option value="36">China</option><option value="185">Christmas Island</option><option value="37">Colombia</option><option value="204">Comoros</option><option value="38">Congo</option><option value="183">Cook Islands</option><option value="268">Costa Rica</option><option value="275">Cote D'Ivoire</option><option value="40">Croatia</option><option value="276">Cuba</option><option value="298">Curacao</option><option value="41">Cyprus</option><option value="42">Czech Republic</option><option value="318">Democratic Republic of the Congo</option><option value="43">Denmark</option><option value="44">Djibouti</option><option value="186">Dominica</option><option value="289">Dominica</option><option value="187">Dominican Republic</option><option value="45">Ecuador</option><option value="46">Egypt</option><option value="47">El Salvador</option><option value="48">Equatorial Guinea</option><option value="49">Eritrea</option><option value="50">Estonia</option><option value="51">Ethiopia</option><option value="189">Falkland Islands</option><option value="191">Faroe Islands</option><option value="52">Fiji</option><option value="53">Finland</option><option value="54">France</option><option value="193">French Guiana</option><option value="277">French Polynesia</option><option value="56">Gabon</option><option value="57">Gambia</option><option value="58">Georgia</option><option value="59">Germany</option><option value="60">Ghana</option><option value="194">Gibraltar</option><option value="61">Greece</option><option value="195">Greenland</option><option value="192">Grenada</option><option value="196">Guadeloupe</option><option value="62">Guam</option><option value="198">Guatemala</option><option value="270">Guernsey</option><option value="63">Guinea</option><option value="65">Guyana</option><option value="200">Haiti</option><option value="66">Honduras</option><option value="67">Hong Kong</option><option value="68">Hungary</option><option value="69">Iceland</option><option value="70">India</option><option value="71">Indonesia</option><option value="278">Iran</option><option value="279">Iraq</option><option value="74">Ireland</option><option value="322">Isle of Man</option><option value="75">Israel</option><option value="76">Italy</option><option value="202">Jamaica</option><option value="78">Japan</option><option value="288">Jersey (Channel Islands)</option><option value="79">Jordan</option><option value="80">Kazakhstan</option><option value="81">Kenya</option><option value="203">Kiribati</option><option value="82">Kuwait</option><option value="83">Kyrgyzstan</option><option value="84">Lao People's Democratic Republic</option><option value="85">Latvia</option><option value="86">Lebanon</option><option value="87">Lesotho</option><option value="88">Liberia</option><option value="281">Libya</option><option value="90">Liechtenstein</option><option value="91">Lithuania</option><option value="92">Luxembourg</option><option value="208">Macau</option><option value="93">Macedonia</option><option value="94">Madagascar</option><option value="95">Malawi</option><option value="96">Malaysia</option><option value="97">Maldives</option><option value="98">Mali</option><option value="99">Malta</option><option value="207">Marshall Islands</option><option value="210">Martinique</option><option value="100">Mauritania</option><option value="212">Mauritius</option><option value="241">Mayotte</option><option value="101">Mexico</option><option value="102">Moldova, Republic of</option><option value="103">Monaco</option><option value="104">Mongolia</option><option value="290">Montenegro</option><option value="294">Montserrat</option><option value="105">Morocco</option><option value="106">Mozambique</option><option value="242">Myanmar</option><option value="107">Namibia</option><option value="108">Nepal</option><option value="109">Netherlands</option><option value="110">Netherlands Antilles</option><option value="213">New Caledonia</option><option value="111">New Zealand</option><option value="112">Nicaragua</option><option value="113">Niger</option><option value="114">Nigeria</option><option value="217">Niue</option><option value="214">Norfolk Island</option><option value="272">North Korea</option><option value="116">Norway</option><option value="117">Oman</option><option value="118">Pakistan</option><option value="222">Palau</option><option value="282">Palestine</option><option value="119">Panama</option><option value="219">Papua New Guinea</option><option value="120">Paraguay</option><option value="121">Peru</option><option value="122">Philippines</option><option value="221">Pitcairn</option><option value="123">Poland</option><option value="124">Portugal</option><option value="253">Puerto Rico</option><option value="126">Qatar</option><option value="315">Republic of Kosovo</option><option value="127">Reunion</option><option value="128">Romania</option><option value="129">Russia</option><option value="130">Rwanda</option><option value="205">Saint Kitts and Nevis</option><option value="206">Saint Lucia</option><option value="237">Saint Vincent and the Grenadines</option><option value="132">Samoa (Independent)</option><option value="227">San Marino</option><option value="255">Sao Tome and Principe</option><option value="133">Saudi Arabia</option><option value="134">Senegal</option><option value="266">Serbia</option><option value="135">Seychelles</option><option value="136">Sierra Leone</option><option value="137">Singapore</option><option value="302">Sint Maarten</option><option value="138">Slovakia</option><option value="139">Slovenia</option><option value="223">Solomon Islands</option><option value="140">Somalia</option><option value="141">South Africa</option><option value="257">South Georgia and the South Sandwich Islands</option><option value="142">South Korea</option><option value="311">South Sudan</option><option value="143">Spain</option><option value="144">Sri Lanka</option><option value="293">Sudan</option><option value="146">Suriname</option><option value="225">Svalbard and Jan Mayen Islands</option><option value="147">Swaziland</option><option value="148">Sweden</option><option value="149">Switzerland</option><option value="285">Syria</option><option value="152">Taiwan</option><option value="260">Tajikistan</option><option value="153">Tanzania</option><option value="154">Thailand</option><option value="233">Timor-Leste</option><option value="155">Togo</option><option value="232">Tonga</option><option value="234">Trinidad and Tobago</option><option value="156">Tunisia</option><option value="157">Turkey</option><option value="158">Turkmenistan</option><option value="287">Turks & Caicos Islands</option><option value="159">Uganda</option><option value="161">Ukraine</option><option value="162">United Arab Emirates</option><option value="262">United Kingdom</option><option value="163">Uruguay</option><option value="165">Uzbekistan</option><option value="239">Vanuatu</option><option value="166">Vatican City State (Holy See)</option><option value="167">Venezuela</option><option value="168">Vietnam</option><option value="169">Virgin Islands (British)</option><option value="238">Virgin Islands (U.S.)</option><option value="188">Western Sahara</option><option value="170">Yemen</option><option value="173">Zambia</option><option value="174">Zimbabwe</option></select> </div> </div> <div class="mc-field-group"> <label for="mce-MMERGE5">Occupation </label> <input type="text" value="" name="MMERGE5" class="" id="mce-MMERGE5"> </div> <div class="mc-field-group"> <label for="mce-MMERGE6">Family Member One </label> <input type="text" value="" name="MMERGE6" class="" id="mce-MMERGE6"> </div> <div class="mc-field-group"> <label for="mce-MMERGE7">Family Member Two </label> <input type="text" value="" name="MMERGE7" class="" id="mce-MMERGE7"> </div> <div class="mc-field-group"> <label for="mce-MMERGE8">Family Member Three </label> <input type="text" value="" name="MMERGE8" class="" id="mce-MMERGE8"> </div> <div class="mc-field-group"> <label for="mce-MMERGE9">Family Member Four </label> <input type="text" value="" name="MMERGE9" class="" id="mce-MMERGE9"> </div> <div id="mce-responses" class="clear"> <div class="response" id="mce-error-response" style="display:none"></div> <div class="response" id="mce-success-response" style="display:none"></div> </div> <!-- real people should not fill this in and expect good things - do not remove this or risk form bot signups--> <div style="position: absolute; left: -5000px;" aria-hidden="true"><input type="text" name="b_026a5026af6a51f971be81150_c8aa191a78" tabindex="-1" value=""></div> <div class="clear"><input type="submit" value="Subscribe" name="subscribe" id="mc-embedded-subscribe" class="button"></div> </div> </form> </div> <script type='text/javascript' src='//s3.amazonaws.com/downloads.mailchimp.com/js/mc-validate.js'></script><script type='text/javascript'>(function($) {window.fnames = new Array(); window.ftypes = new Array();fnames[0]='EMAIL';ftypes[0]='email';fnames[1]='FNAME';ftypes[1]='text';fnames[2]='LNAME';ftypes[2]='text';fnames[3]='MMERGE3';ftypes[3]='phone';fnames[4]='MMERGE4';ftypes[4]='address';fnames[5]='MMERGE5';ftypes[5]='text';fnames[6]='MMERGE6';ftypes[6]='text';fnames[7]='MMERGE7';ftypes[7]='text';fnames[8]='MMERGE8';ftypes[8]='text';fnames[9]='MMERGE9';ftypes[9]='text';}(jQuery));var $mcj = jQuery.noConflict(true);</script> <!--End mc_embed_signup-->