Associate: Manufacturer's Agent- Application for Membership

Any Person being a Manufacturers' Agent shall be eligible to become an Associate Member (Non-Voting) provided their principal business is performing in Canada the sales and marketing functions with architects, engineers, contractors and retailers through wholesale distributors for one or more CIPH members in a defined, exclusive sales territory. The agent shall not be engaged in the installation of or direct sales to consumers of Plumbing and Heating products. The company must have been in business based 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 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 *

Relationship with existing CIPH Members *

Is the company’s primary business performing the SALES AND MARKETING functions for a CIPH member manufacturer with architects, engineers, contractors and retailers?

THROUGH WHOLESALER DISTRIBUTORS? *

Which MEMBER(S) OF CIPH does the company currently represent in an EXCLUSIVE sales territory? *

What is the company’s geographic marketing area for these products?

List other plumbing, heating or hydronics manufacturers: *

As part of your business do you Install Products? *

As part of your business do you sell products to the consumer? *

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

How many employees does the company have 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.

CIPH MEMBER MANUFACTURERS & MASTER DISTRIBUTORS *

LIST ALL CIPH MEMBER MANUFACTURERS & MASTER DISTRIBUTORS YOUR AGENCY REPRESENTS – IF MORE THAN 4 PLEASE ATTACH LIST:

Basic Dues (Canadian Annual Including subsidiaries) *

Please select appropriate option

$695

Additional Dues *

LOCATION DUES (IF ANY) $150 for each additional region in which your agency has a sales

9 #Locations x $150 (Maximum - 9 Locations)

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's Agent- Application for Membership

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