Become A Member Name(Required) First Last Professional Qualification(Required) Current and Active Affiliation(Required) Role(Required) Are you a Trainee?(Required) Yes No How Did You Hear About CanHaem?(Required)Were You Recommend by a CanHaem Member?(Required) Yes No If yes, Who Application For(Required) Active Member Associate Member CanHaem is an active association and a leader in care, education and research in Hemoglobinopathy in Canada. Did you know that CanHaem has several active subcommittees for active members? Let us know if you’d be interested to participate and like to also apply in one of them (in the form list them) : Educational committee, nursing committee, research committee, registry committee, board of directors (elected at the AGM). Interested in joining an active subcommittee? Yes No Subcommittees Educational Committee Nursing Committee Research Committee Registry Committee *To become an active member, applicants need to have an active affiliation in Health Care program in Canada (be an allied health care worked working in Canada). Individuals working for pharmaceutical companies are welcome to apply for CanHaem membership but will be granted permission to become associate member. Applicants from outside Canada or those not directly affiliated with a health care program may also be considered to become associate member. Of note, associate members may not participate in subcommittees. Email(Required) We would appreciate if you could preferentially use your professional email from your affiliated health care program rather than a personal email addressWould you agree to share your contact information with other CanHaem members?(Required) Yes No Tell Us More About Yourself(Required)CAPTCHACommentsThis field is for validation purposes and should be left unchanged. Δ