Neighbourhood Pharmacy Association of Canada: Associates

Join The Neighbourhood Pharmacy Association of Canada

STEP 2

Complete your application

All sensitive information will be held in strict confidence. Please complete all pages of form. Information should be typed, or clearly printed. Membership is effective upon receipt of your completed application form and full payment pending the approval of The Neighbourhood Pharmacy Association of Canada Council of Representatives.

Associate dues are based on Annual Sales to The Neighbourhood Pharmacy Association of Canada Retail Members, either directly or through wholesalers.
An Associate is defined as a company with a distinct name and/or division that has an independent sales and marketing team.
Becoming and Associate entitles each company to request one appointment with each The Neighbourhood Pharmacy Association of Canada Retail Member during the The Neighbourhood Pharmacy Association of Canada Annual Executive Exchange Conference.

You can download a PDF of the Associate application form or please fill out the following:

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Section 1 - Company Information

* Company Name:

* Company Address:

* City:

* State - Province:

* ZIP/Postal Code:

Phone:

Fax:

Company Description (to be used in announcement to Retail and Associate Members of your membership):

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Contact Information

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Primary Contact

* Name:

Title:

* Phone:

* Email:

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Secondary Contact

Name:

Title:

Phone:

Email:

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President/CEO

* Name:

Title:

* Direct Phone:

* Email:

* Should this individual be on our distribution list for member communications:

Yes

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Sr. Marketing Contact

* Name:

Title:

* Direct Phone:

* Email:

* Should this individual be on our distribution list for member communications:

Yes

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Sr. Sales Contact

* Name:

Title:

* Direct Phone:

* Email:

* Should this individual be on our distribution list for member communications:

Yes

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Section 2 - Please indicate which categories your company represents:

Prescription

OTC

Toiletries, Cosmetics, Fragrances

Natural Health Products

Rx Software

Stationery and Cards

Manufacturer's Agent/Broker

Wholesale/Distributor

Market Research

General Merchandise

Photo/Video

Grocery/Confectionery

Operational Services

Health and Beauty

Trade Publishers

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The Neighbourhood Pharmacy Association of Canada employees hold privacy of personal information to be of paramount importance and share a common commitment to safeguarding personal information pursuant to privacy laws such as the Canadian federal Personal Information Protection and Electronic Documents Act (PIPEDA), and corresponding Canadian provincial privacy legislation.

* Are you a member of NACDS:

Yes

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Section 3 - Member Referral

To verify your good standing as an Associate member of The Neighbourhood Pharmacy Association of Canada, we require references from two The Neighbourhood Pharmacy Association of Canada Retail members.

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First The Neighbourhood Pharmacy Association of Canada Retail Reference:

* Name:

Title:

* Company:

* Phone:

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Second The Neighbourhood Pharmacy Association of Canada Retail Reference:

* Name:

Title:

* Company:

* Phone:

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Section 4 - Dues Schedule

Company 1:

Company 2:

Company 3:

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	Annual Sales to The Neighbourhood Pharmacy Association of Canada Members	Dues	HST 13%	Total
Cat 1	Less than or equal to $10 million	$4,500.00	$585.00	$5,085.00
Cat 3	$10 - $20 million	$8,000.00	$1040.00	$9,040.00
Cat 3	$21 - $50 million	$11,000.00	$1430.00	$12,430.00
Cat 4	Over $50 million	$15,000.00	$1,950.00	$16,950.00
Cat 5	Professional Services Company: includes advertising agencies, data processing companies, financial analysts, insurance consultants, market research companies, trade publishers, and other such services.	$3,000.00	$390.00	$3,390.00
Cat 6	Manufacturer Agent/Broker: With one membership fee you can represent up to three (3) companies and are entitled to request one appointment with each The Neighbourhood Pharmacy Association of Canada Retail Member at the Annual Executive Exchange Conference.	$4,500.00	$585.00	$5,085.00

STEP 2

Section 1 - Company Information

Contact Information

Primary Contact

Secondary Contact

President/CEO

Sr. Marketing Contact

Sr. Sales Contact

Section 2 - Please indicate which categories your company represents:

Section 3 - Member Referral

First The Neighbourhood Pharmacy Association of Canada Retail Reference:

Second The Neighbourhood Pharmacy Association of Canada Retail Reference:

Section 4 - Dues Schedule

Cat 1

Cat 3

Cat 3

Cat 4

Cat 5

Cat 6