Membership – Professional

    Application & Payment


    Contact Information

    ** = Required

    **First Name:

    **Last Name:

    **Email Address:

    Telephone Number:




    Postal Code:


    Membership Category (Required):

    New application or renewal?:


    About You

    If you are currently working, what is your Job Title?

    If you are currently working, what is the name of your Company?

    What is your area of work or study/major?


    Declarations (Required)

    For each item below, select "Yes" if you agree, "No" if you disagree.


      I understand and support the objectives of WISE NL.

      In accordance with the Canadian Ant-Spam Legislation (CASL), I grant permission to include my email address in the WISE NL email distribution list.

      I understand that WISE NL collects this information for the internal use of WISE NL only and will not share this information with third parties without expressed permission.


    Submit Application

    By submitting this form, you're granting: WISE NL, PO Box 23176, Churchill Square, St. John's, NL A1B 4J9, Canada,; permission to email you.

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    Online payment for professional membership is $26.75, which includes a transaction fee.

    After submitting this form you will be redirected to PayPal. No PayPal account is required if paying by credit card.

    If you wish to pay by cash or cheque, which does not incur a transaction fee, do not used this form. Please submit a paper application.