2021 OPIRG Brock Membership Form
Hello and thank you for your interest in becoming a member of OPIRG Brock!
If you are looking to OPT-IN to OPIRG Brock and become a member, please fill in this form. Following the completion of this form, your membership will be sent to our Board of Directors, and you will be contacted to pay the membership fee. By holding an OPIRG Brock membership, you are able to run or apply for the OPIRG Brock Board of Directors and vote in the Annual General Meeting in September.
To maintain a membership-in-good-standing, you must agree to and uphold the OPIRG Brock Safer Space Policy. (
), as well as other relevant OPIRG Brock policies.
For anyone using this form who is not a CUPE 4207 member, upon approval of your membership by the OPIRG Brock Board of Directors, you will receive an email on the follow up steps for the payment of your annual membership fees. There are a range of options for membership fees ($0, $10, $20, sliding scale). If paying the membership fee creates a financial barrier for you from being a member of OPIRG Brock, please choose the option of a 'Community Access Membership'. If you are paying via Paypal, you will receive an email with further instructions on how to do this.
To pay your membership fee, you have multiple options:
- Being a member of CUPE 4207 (fees are paid through union membership)
- One-time payment by e-transferring the OPIRG Brock Paypal (preferred)
- Sign up to become a regular Patron on our Patreon account ($5 - membership come to the Board of Directors for review after 2 months of payments, $10+ membership is considered immediately). Each Patreon level results in perks and a level of buy in focused on keeping OPIRG Brock alive. To sign up this way, please visit
- One time cash payment or cheque to an OPIRG Brock staff or Board member (To do this, we will email you to set up a COVID-19 safety process for receiving your payment)
**If you work with an organization that would like a Community Organization Membership, please indicate that on the form below and we will send you a follow up email. Even if you have not cleared this with the other members of your organization, if you are at all interested, please click yes and that will allow us to send you more details to take back to your group.
In the meantime, if you have any questions about online OPT-IN's or OPIRG Brock in general, please feel free to email
Phone number (not required)
Are you a CUPE 4207 Member? (
I don't know
Student or Community Member?
High School Student
Post-Secondary Student (Brock University, Niagara College, or any private institution)
Community Member (all non-students)
Were you a member of OPIRG Brock in 2020?
If you were not previously a member, please provide a brief background experience with OPIRG Brock, Niagara, or any other cultural, activist, and/or organizing communities.
Please check one box
By signing below, I indicate that to my knowledge I am in good standing with OPIRG Brock and wish to join its membership. I understand that my application may be rejected or my membership may be revoked at any time if my actions conflict with the mandate, Safe Space Policy or any other policies of OPIRG Brock, jeopardize the reputation or future of OPIRG Brock, or otherwise causes harm to the community. At this time my membership fee would be refunded in person or by mail to the address provided. NOTE: Any person who is a member of another Chapter of the Ontario Research group is not eligible for membership in the Brock chapter.
I do not agree.
Type of Membership
Valid until December 31, 2021. At this time you will be contacted about updating your membership.
Check all that apply for membership fee
CUPE 4207 member ($0)
Individual Membership ($10-$20, sliding scale, through cash, e-transfer, or Patreon)
Individual Community Access Membership ($0)
Organization/ Community Group (Action Group) Membership ($10 per month paid on Patreon)
Niagara Business Membership ($20 per month paid on Patreon)
Community Support Membership (additional anonymous $10 donation to fund the Community Access Memberships)
'Keep OPIRG alive' Donation (additional one time $30-$50 donation to keep things going at OPIRG Brock)
Total Fees (Sum of memberships selected above)
Method of paying membership fee.
Not applicable (Select if accessing a Community Access Membership or CUPE 4207 member)
One-time payment by e-transferring amount indicated to OPIRG Brock Paypal
Signed up to become a regular Patron on our Patreon account (using $5, $10, $20, or $30 levels)
One time cash payment or cheque to an OPIRG Brock staff or Board member (To do this, we will email you to set up a COVID-19 safety process for receiving your payment)
Are you part of an organization that would like a Community Organization Membership?
If yes, please list the organization and the email you would like to be contacted.
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This form was created inside of OPIRG Brock.