2011 / 2012 CTRA New Member Application Form

Once you have joined as a new member and your application has been reviewed and processed you will be sent an e-letter of confirmation and "Member's Only" login information. If you are using the on-line payment below you will get a e-payment confirmation from PayPal.

Membership Criteria: Individuals employed, or qualified to be employed, in the field of Therapeutic Recreation.

Student Membership Criteria: Individuals who are full-time students (three or more TR courses) at an accredited college or university.

CTRA Membership Year is April 1 - March 31 (except for ATRA members which is May 1st). New Members joining after September 30th of each year pay half the yearly fee.

Important Joint Member Information - ATRA, BCTRA & TRAAC Click Here

Please note that all information on this form must be entered. If any information is incomplete your form will not be accepted.

Member Information

Full Name

Full Home Address

Home/Cell Number

E-mail address (that you would like CTRA info sent to)

Work Phone # or Educational Institution Phone # (students)

Name of Current Employer or Name of Educational Institution (students)

Job Title or Program Title (students)

Employment Status (check all that apply)

Permanent
Temporary
Full Time
Part Time
Casual
Not currently employed

Years Employed with Current Employer or NA for Students

Primary Employment Setting (For example, Active Rehabilitation, Long Term Care, Palliative etc.)

Primary Client Population (For example - Geriatric, Children, etc.) or NA for students

Total Years of Paid TR Work Experience or NA (student)

Education Levels Obtained - check all that apply

High school (only required if this was highest level of education)
Certificate 1 year
Diploma 1 year
Diploma 2 years
Degree 3 years
Degree 4 years
Masters
PhD

Name of provincial association if you are a member or NA if you are not

Provincial association membership # or NA if you are not:

Provincial membership category

I am a certified member of NCTRC - CTRS:

Certification ID# or NA

Please indicate committees you would be interested in joining if needed:

National TR Week
Nominations and Awards
Translation
Strategic Planning
Membership
Promotion and Marketing
Education/Professional Development
Certification
Not Interested

Please include me in the members only membership directory:

Yes - my personal information may be shared in the members only directory
No - my personal information may not be shared in the members only directory

Please check the appropriate membership fee:

CTRA Full Member with Provincial Membership: $50.00
CTRA Full Member without Provincial Membership: $100.00
CTRA Student Member with Provincial Membership: $25.00
CTRA Student Member without Provincial Membership: $50.00
CTRA Mid Yr with Provincial Membership: $25.00
CTRA Mid Yr without Provincial Membership: $ 50.00
CTRA Mid Yr student with Provincial Membership: $ 12.50
CTRA Mid Yr student without Provincial Membership: $25.00

I understand and agree that all the information I have provided is correct. I understand that if I have provided any false information or misrepresented myself in any way I risk the loss of my membership status without reimbursement:

Payment

I wish to submit my payment using PayPal Now (See PayPal button below - you do not require a PayPal account if using a credit card)
I wish to mail a cheque to CTRA (within 1 week of this form submission) If so, please print this form before clicking submit and mail it along with payment. Please allow 4-6 weeks for processing.
I have paid my CTRA fee to my provincial association (ATRA, BCTRA & TRAAC only)

Don't forget to click the submit button prior to clicking the PayPal button or leaving this page!

Please send cheques to:

Canadian Therapeutic Recreation Association
P.O. Box 448
Russell, ON
K4R 1E3

Thank you for continuing to support CTRA!