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OTDBASE Organization/Institutition Subscription Form

If you wish to subscribe to OTDBASE at US$400.00 per year, print this form, fill it out and mail it to:

OTDBASE
c/o Marilyn Ernest-Conibear
#401 - 1485 West 6th Ave.
Vancouver, BC V6H 4G1
CANADA
Please include encoded cheque, bank draft or money order payment of US$400.00 made out to "OTDBASE"

All Information is REQUIRED, except fax number if not available.

Organization/Institution Name:
Mailing Address: 
State/Province:
Postal/Zip Code:
Country:
   
Contact Person & Title:
Phone Number:
Fax Number (if available):
Institution/Organization Email Address:
USERNAME (between 5 & 10 characters): 
PASSWORD (between 5 & 10 characters):

 

Once your form information is submitted and your Money Order/check arrives your account will be activated. Your contact person will receive a notice by email informing you of your activation to OTDBASE.

 

 

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