Quantum Industry Canada (QIC) Membership and Affiliate Application

Welcome to QIC's membership and affiliate application!

We're thrilled you're considering joining our dynamic community of quantum innovators and industry leaders.

QIC is a national, industry-led non-profit consortium uniting Canada's quantum technology companies and allied organizations to strengthen and connect the country's quantum sector. Our mission is to translate Canadian quantum capabilities into global business success and national prosperity.

Please take a few minutes to complete this application. Your responses will help us evaluate alignment and determine how we might work together to grow Canada's quantum innovation ecosystem.

Key Information:

Questions? Contact us at info@quantumindustrycanada.ca


Sign in to Google to save your progress. Learn more
Email *
What's your first name? *
What's your last name? *
What's the legal name of your organization? *
What year was your organization founded? *
What is your job title? *
Please provide the URL for your organization's website. *
What is the address of your organization's headquarters? *
What's the size of your organization? *
Please select the option that best describes your corporate structure in Canada: *
Which of the following best describes your organization? *
Please describe your organization in a few sentences. *
Please explain in a few sentences your organization's interest in or connection to quantum information science and technology and QIC's mission. *
What is your organization most looking to gain from your membership with Quantum Industry Canada? (Select all that apply)
*
Required
To the best of your knowledge, is your organization or any of its staff currently affiliated with or in receipt of funding or in-kind support from one or more of the institutions on the Government of Canada’s list of Named Research Organizations?
 
Note: In line with the Government of Canada’s Policy on Sensitive Research and Affiliations of Concern, only currently held affiliations are of concern to QIC; past affiliations will not affect your application.
*
Are you currently a member of any other industry consortia related to quantum or associated technologies? If yes, please specify which ones. *
Would you like to subscribe to QIC's newsletter? (You can unsubscribe at any time.) *
Anything else you'd like to share with us as we review your application?
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Quantum Industry Canada.

Does this form look suspicious? Report