Canadian Society of Nutrition Management (CSNM), Student Membership Subscription Personal Info

Member Login

Student Membership Personal Info

Member #

CSNM Chapter

Designation

Title

First Name *

Middle Name

Last Name *

Birthdate

Language

Address

Address Line 1 *

Address Line 2

City *

Country *

Province/State *

Province/State

Postal/Zip *

Phone *

Phone Ext

Fax

Email *

Please select a CSNM Accredited School Name from the list. CSNM Student membership is only available to students enrolled in a CSNM accredited program.
If your school name does not appear in the list this Application can't be processed, for further clarification please contact the CSNM office csnm@csnm.ca

Enter the College Code supplied by your Institution. College Code is case sensitive. If you were not supplied a code please enter "None"

College Code

Institution

Institution Address

Address Line 1

Address Line 2

City

Country

Province/State

Postal/Zip

Program

Graduation Date

Photo

Username *

Password *

Password Confirmation *