Corporate Profile

Sole ProprietorshipPartnershipCorporation

(If 50% or more, please provide details in cover letter)

YesNo

(If yes, please provide details in cover letter)

YesNo

(If yes, please provide details in cover letter)

AcademicGovernmentIndustryManufacturingOther CCIL member FirmOther non-Member Consulting, Testing and Inspection FirmsTrade Group

(Check where applicable and provide pertinent details of affiliation in cover letter)

1.
2.
3.
YesNo


(If no please explain in cover letter)

(If yes please explain in cover letter)

Facilities




Scope of Services

References

1.
2.
3.

Division

PrimaryAdditional
PrimaryAdditional
PrimaryAdditional

Region

Head OfficeBranches
Head OfficeBranches
Head OfficeBranches

Delegates

Undertaking

Operate under the direct supervision of one or more professional engineers and/or professional chemists or a person or persons having acceptable equivalent professional status as deemed sufficient by the National Directors.

Agreement

I have read the Summary of Conditions of CCIL Membership and the Schedule of Dues and agree that the information given in this application is true and correct as of the date of application; that the applicant firm will adhere to all the requirements of the Summary of Conditions of CCIL Membership; and that the applicant firm will accept the decision of the Board of Directors with respect to this application

Dues for the full year are to be submitted with membership application together with the required administration fee (see attached Schedule of Dues). Adjustment will be made on the following year’s dues depending on the number of months between start of membership and end of CCIL fiscal year.

MAIL TO:

Canadian Council of Independent Laboratories

P.O. Box 41027

Ottawa, Ontario K1G 5K9

For Office Use Only