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Member Registration

NOTE: Please use a prefix of "999" plus a random 5-digit number if you are out of Ontario and don't have a valid CPSO# assigned. e.g. 99900001
Fields marked with an asterisk (*) are required.

CPSO #: *
First Name: *
Last Name: *
E-mail: *
Password: *
Verify Password: *
Office Address:
Phone:
Enter Verification Code: Refresh the image