Membership Application Form (NEW Membership and RENEWALs)
  1. First Name(*)
    Please enter your first name.
  2. Last Name(*)
    Please enter your last name.
  3. E-mail(*)
    Please enter your email address.
  4. Address(*)
    Please enter your street address.
  5. City(*)
    What City?
  6. Province / State(*)
    What Province or State are you from?
  7. Postal / Zip Code(*)
    What is your postal code or zip code?
  8. Employer Name(*)
    What is your employers name?
  9. Type Of Employment(*)
    Please select type of employment.
  10. Job Title(*)
    What is your current job title?
  11. Year of Graduation from Pharmacy Program(*)
    What year did you graduate?
  12. CPBC Registration #
    What is your CPBC Registration Number?
  13. Membership Options
    Invalid Input
  14. Select Payment Method
  15. If name on payment method is different then name on this application, please list
    Invalid Input
  16. Total
    0.00 CAD
  17. Invalid Input

Contact Details

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Contact Us

Pharmacy Technician Society of British Columbia
Address

Suite # 583
7360 - 137 Street
Surrey
British Columbia
V3W 1A3

Email
info@ptsbc.org