Relief Membership application or renewal Form

This form includes a section for the payment of the annual fees. By completing and submitting this secure form with your payment information, you are consenting to the payment by credit card of the one-year $40 membership fee.

Contact information

First name

Last name

Phone number

Please help us improve and maintain our services by answering the following questions

Language

Specify if desired

The first 3 characters of your postal code

Year of birth

Gender identity

Please specify your gender identity

How did you hear about Relief?

Billing information

Address

City

Province

Required field for residents of Canada and the United States

Postal Code

Country

Payment Information

Name on the card

Card number

CVV

Card type

VisaMastercard

By checking the box, you consent – and understand that you can withdraw this consent at any time – to Relief collecting, using, disclosing, and processing your personal information for the following purposes:

· To confirm your identity, verify the accuracy of your personal information, and update it;

· To communicate with you, respond to your questions or requests, or address your complaints;

· To comply with legal and regulatory obligations;

· To update your member/client/donor file;

· To register you for one of our services;

· To grant you access to our platforms;

· To process payment for a service or donation;

· To issue and send receipts to you.

For more information about your rights and our personal information protection practices, we invite you to consult Relief’s Privacy Notice available here.

Contact Information