Become a Grower Member Become a grower member Last name Name Company name Address City Province ProvincePrince Edward IslandAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioQuebecSaskatchewanYukon Postal code Home phone Cell phone Email Address Gross sales Gross sales$0 - $99,999$100,000 - $249,999$250,000 - $499,999$500,000 - $749,999$750,000 - $999,999$1,000,000 - $1,249,999$1,250,000 - $1,499,999$1,500,000 - $1,749,999$1,750,000 - $1,999,999$2,000,000 - $2,249,999$2,250,000 - $2,499,999$2,500,000 - $2,749,999$2,750,000 - $2,999,999$3,000,000 - $3,249,999$3,250,000 - $3,499,999$3,500,000 - $3,749,999$3,750,000 - $3,999,999$4,000,000 - $4,249,999$4,250,000 - $4,499,999$4,500,000 - $4,749,999$4,750,000 - $4,999,999$5,000,000 - $5,249,999$5,250,000 - $5,499,999$5,500,000 - $5,749,999$5,750,000 - $5,999,999$6,000,000 - $6,249,999$6,250,000 - $6,499,999$6,500,000 - $6,749,999$6,750,000 - $6,999,999$7,000,000 - $7,249,999$7,250,000 - $7,499,999 Your Fee: $250 + HST Your Fee: $400 + HST Your Fee: $900 + HST Your Fee: $1400 + HST Your Fee: $1900 + HST Your Fee: $2400 + HST Your Fee: $2900 + HST Your Fee: $3400 + HST Your Fee: $3900 + HST Your Fee: $4400 + HST Your Fee: $4900 + HST Your Fee: $5400 + HST Your Fee: $5900 + HST Your Fee: $6400 + HST Your Fee: $6900 + HST Your Fee: $7400 + HST Your Fee: $7900 + HST Your Fee: $8400 + HST Your Fee: $8900 + HST Your Fee: $9400 + HST Your Fee: $9900 + HST Your Fee: $10400 + HST Your Fee: $10900 + HST Your Fee: $11400 + HST Your Fee: $11900 + HST Your Fee: $12400 + HST Your Fee: $12900 + HST Your Fee: $13400 + HST Your Fee: $13900 + HST Your Fee: $14400 + HST Your Fee: $14900 + HST Payment Method (please check one)* Payment Method (please check one)* Interac e-transfer Invoice Credit card Call the office for assistance. Call the office for assistance. If you are paying by credit card please call us to make your payment: (902) 368-2757 Would you like to be added to PEI Aquaculture Alliance mailing and email distribution lists to receive industry news and updates? (please check one)* Would you like to be added to PEI Aquaculture Alliance mailing and email distribution lists to receive industry news and updates? (please check one)* Yes No Please enter any other emails you would like to receive the newsletter (Optional) What is your most preferred method of communication? What is your most preferred method of communication? Email Mail Phone What aspects of the industry are you involved in.(Select All That Apply) What aspects of the industry are you involved in.(Select All That Apply) Finfish Mussels Oysters Processor * * I authorize the verification of the information provided on this form. I acknowledge that my electronic signature on this document is legally equivalent to my handwritten signature. * Submit