Associate:Manufacturer - Application for Membership

Any person being a manufacturer with direct employees’ resident in Canada shall be eligible to become an Associate Member (Non-Voting) provided that an important portion of their business revenue is derived from the supply of Plumbing and Heating product lines into Canada. These products will be sold and inventoried through the wholesale distribution industry in at least five provinces. Such members shall not be directly engaged in the installation of, or sales to consumers of Plumbing and Heating products. The company must have been in business in Canada for a reasonable period of time as determined by the Board.

The undersigned hereby applies for membership in the Canadian Institute of Plumbing & Heating canadien de and, if accepted, agrees to comply with all the provisions of the By-Laws of the Institute. The undersigned agrees to pay annual dues in accordance with the schedule approved by the Board of Directors of the Institute.

Fields marked with an * are required.

Application for Membership
Please calculate annual membership dues based on last year's Canadian sales. Return your application to CIPH with dues payment. Dues payments will not be processed until your application has been approved. Dues are payable each May 1st. The Institute’s fiscal year is May 1st to April 30th. The CIPH Board of Directors will review your application at the next Board Meeting.

Company Name *

Address Line 1 *

City *

Province *

Postal Code *

Phone *

Fax

Email *

Website

President of Company *

Applicant Name *

Position *

Signature *

Please check where appropriate *

Does the company have a substantial investment in a factory and/or machinery in Canada used to manufacture plumbing, heating, hydronics, waterworks and industrial products?

List the products you manufacture that fall into these categories *

List the general types of plumbing, heating, hydronics, waterworks and industrial products you manufacture in Canada: (attach a list if more space is required)

Date company established? *

Year:

How long has it been under the present ownership *

Years:

Is it registered or incorporated in Canada *

Yes

Federally

Provincially

Is the company affiliated with any other Canadian company *

Is the other company in the plumbing and heating industry *

Please give the name of the other company from the previous question and explain the relationship *

Put N/A if 'no' was selected in the previous question

What percentage of the company’s sales are to *

Wholesaler distributors *	Contractors *	Builders *	Consumers *	Retailers *	Industrial *	Others (specify) *

How many employees does the company have in Canada *

If Applicable, Please list the Manufacturer's Agent companies who represent your products in Canada

Canada's Anti-Spam Legislation fulfillment: Yes, I agree to receive e-communications from CIPH

List key employees of the company

Name	Title	Location	Email

To assist the CIPH Membership committee with their recommendation *

Please indicate top three reasons why you want to become a member of the institute

2024/2025 Dues Calculation Form
The following dues schedule has been approved by the Board of Directors of CIPH. Please calculate annual membership dues based on last year's Canadian sales. Effective May 1, 2024 for the CIPH fiscal year May 1, 2024 to April 30, 2025. Dues are payable May 1 or with your application for CIPH Membership.

Please list subsidiaries, if any *

Basic Dues (Canadian Annual Including subsidiaries) *

Please select appropriate option.

On Sales of over $50 million *	On Sales of $25 to $50 million *	On Sales of $10 to $25 million *	On Sales of over $1 to $10 million *	Basic Dues *
$6,075	$5,180	$3,670	$2,130

Additional Dues *

$150 Dues for each of the ten provinces in which your plumbing, heating, hydronics, waterworks and industrial products are distributed and sold either directly or indirectly.

#Provinces x $150 (Maximum - 10 Provinces or $1,500)

Annual dues / Subtotal (Basic dues plus additional dues) *

TOTAL DUES (Annual dues / Subtotal + GST) *

Signing Officer *

Title *

Signature *

Please fill out full Name

Associate:Manufacturer - Application for Membership

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