Application Fields

Contact Information

First Name:

Last Name:

Company Name:

Mailing Address:

Daytime Phone Number:

Cell Phone Number:

Fax Number:

E-Mail Address:

Website Address:

Creative Profile

Membership Type

Professional Member
Associate Member
Student Member

Payment

Method of Payment: In Person (cash or cheque)
Online

Cheques can be made out to Queen Street Studios Inc.

Disclaimer

I certify that the above statements to be a complete and accurate representation of my background. I understand that some information provided on this form will be used in the QSS membership directory or for mailing lists, which are occasionally provided to sponsors of QSS initiatives or to potential clients.

Applications are reviewed and verified bt the Membership Committee. Information will be verified and treated as confidential and will not be disclosed to any person who is not a part of the review process. If accepted as a member, you will be notified directly by a QSS representative and will receive confirmation via e-mail.

I Agree