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Quasep Become A Member

Become a Member

Thank you for expressing your interest in becoming a QUASEP member.
In order to process your membership request, please complete the following STEPS:
Step 1

* Temporary ID #:

* First Name:
* Last Name:
* Company Name:
* Position:
* Street Address:
* City:
* Province:
* Postal code:
* Phone:
Cell Phone:
* Email:
Fax:
* Method of contact:

* Is mailing address the same as the company address?

Yes No

* If no, please enter mailing address

* Street Address:

* City:

* Province:

* Postal code:

* Are there multiple locations associated with this company?

Yes No

* If yes, please specify # locations

* Location Name:

Street Address:

City:

Province:

Postal code:

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* Do you belong to a purchasing group?
Yes No

* If yes,please specify

Comments:

Step 2

Review the *Terms and Conditions

Step 3

I,
accept the QUASEP Terms and Conditions on behalf of
and I have authority to bind it.

Step 4

Quebec

7505, boulevard Taschereau, Bureau 106
Brossard, QC, J4Y 1A2

Toll Free: 1.844.486.4344
Fax: 1.855.710.7727

Ontario

811 Islington Avenue
Toronto, ON, M8Z 5W8

Toll Free: 1.800.331.9433
Fax: 416.255.6628

Western Canada

1-1585 Cliveden Avenue
Delta, B.C. V3M 6M1

Toll Free: 1.888.638.9988 ext. 221
Fax: 604.540.0511

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