Registration Form | APS CBC/SRC

I wish to become a member of the ASSOCIATION OF PROFESSIONALS AND SUPERVISORS OF THE CANADIAN BROADCASTING CORPORATION and hereby request to become an active member of the said association and I authorize the Association to be my sole representative regarding collective negotiations. I shall abide by the By-Laws of the aforementioned union.

Employed by: Canadian Broadcasting Corporation

FREE LIFE INSURANCE FOR APS MEMBERS IN GOOD STANDING
BASIC COVERAGE PROTECTION WITH BENEVA INSURANCE

MEMBER IN GOOD STANDING: $ 10,000
SPOUSE OR COMMON-LAW PARTNER: $ 6,000
PER DEPENDENT CHILD: $ 4,000

Fill out this Registration Form and check the box « submit this information and accept the right to have life insurance granted by APS and its provider »

For more information:

APS / Beneva – Free Life Insurance Coverage

Registration

"*" indicates required fields

Member state*

First name*

Name*

Address*

Address City Province Postal code

Residence phone

Cell phone

Work phone

Ext no.

Service

Employee number

Title

Email*

Life insurance

I wish to*

submit this information and accept the right to have life insurance granted by APS and its provider

Not provide this information and thereby waive the right to life insurance granted by APS and its provider

Language*

French

English

Gender*

Male

Female

Other

Date of birth*

Name

This field is for validation purposes and should be left unchanged.