CMDS National Office
Unit B, 246 Main Street
Steinbach, MB
Canada R5G 1Y8

Tel: 204-326-2523
Fax: 204-326-3098
Toll-free: 1-888-256-8653
Email: office@cmdscanada.org


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If you are interested in a CMDS Membership, please fill out the form below and submit on-line. If you require more information, you can indicate it below or see the "About CMDS" or the "Contact Us" page.


Note: None of the information submitted will be disclosed to a third party, sold or given as part of a list, or used for purposes other than providing a means of contact between you and CMDS.


Full acceptance of our Statement of Faith is required for a full "Regular" membership.
Click here to view.


Please fill out the form below and click the "Submit" button,
to send the information to the CMDS National Office.

Membership
Request
 Regular Membership (requires signing Statement of Faith.)
Affiliate Membership
Please send me more information
I have read and agree with
CMDS' Statement of Faith
 Yes
No
First Name
Last Name
Address1
Address2
City
Province
Postal Code
Home Phone
Office Phone
Fax Number
E-mail Address
Gender
 Male
Female
Marital Status
Spouse's Name
(if applicable)
Professional Degree
(obtained or expected)
Year of Graduation
(achieved or expected)
Name of School
Residency
Specialty
Type of Practice
How did you find out
about CMDS?

We thank you for your Membership Application.

Please click the "Submit" button to send the form to the CMDS National Office. You will be redirected to a Secure On-line Payments page. Please scroll down to the section entitled: Dues Payments and fill in your credit card information, to complete your Membership Application.

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We pray that you will find your experience with CMDS both informative and rewarding.