CCPU Membership Application
Caribbean-Canadian Parents United is a grassroots, membership-based, non-profit organization; aimed at improving well-being for Caribbean-Canadian families. Currently serving: Ontario regions: Peel, Durham, Dufferin, GTA, Halton, and York.

CARIBBEAN-CANADIAN COMMUNITY is defined as: All women, men , youth and children who
1. are native to or descending from the Caribbean regions/territories/nations - INCLUDING ALL races/ancestries/ethnicities; AND
2. self-identify as "Caribbean" and/or "Caribbean-Canadian"; AND
3. reside in Canada.

VISION: A thriving Caribbean-Canadian community.
MISSION: To connect and enable Caribbean-Canadian parents.

Membership fee: $30/year/Caribbean-Canadian parent/guardian.
Please complete this form to apply for general membership. One application per Caribbean-Canadian parent/guardian.

Email address *
Are you a member of Caribbean Women's Society? www.ourcws.com *
Last Name *
Your answer
I have read, understand and accept the membership requirements and benefits. www.ccpunited.ca/membership *
Required
Date *
MM
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DD
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YYYY
Please select your kid(s) age range(s)
kids under 3 years old
kids between 3 and 6 years old
kids between 7 and 9 years old
kids between 10 and 13 years old
kids between 14 and 18 years old
kids over 18 years old
1
2
3
4
5
Where is your region of residence? *
As a member of Caribbean-Canadian Parents United (CCPU), I agree to fulfill the following expectations, with effort and enthusiasm (MUST CHECK ALL BOXES): *
Required
Are you a member of Caribbean-Canadian Chamber of Commerce & Community? www.c5ontario.com *
Caribbean-Canadian Parents United
Promo code (if applicable)
Your answer
Preferred method of payment for the $30 (per Caribbean-Canadian parent/guardian) annual membership fee *
I, the undersigned, do hereby certify that a. the information submitted on this application is true and accurate; b. I severally covenant and agree to adhere to the by-laws, policies and regulations of Caribbean-Canadian Parents United. *
Required
Phone Number *
Your answer
Which Caribbean country(ies) do you represent? *
Your answer
First Name *
Your answer
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