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Affiliate Membership Application

This is the application form for an Affliliate membership. If you have any questions, please contact Zaria Pucknell at

Account Information

Required field: Enter valid email address
Your RGD URL: https// Required field: Enter a unique RGD URL to appear after[profile-refernce]
Required field: Enter valid phone number
Warning: All links need to start with http:// or https://

Mailing Address

Enter the full name of your province/state

Billing Address

Enter the full name of your province/state


Personal Information

Please describe any intersectionalities that are important to your identity. (We plan to use this information to better understand RGD's Membership and ensure we are accessible, relevant and inclusive to all. This information will not be shared publicly.)


Paste the full url to your social media account. For example: ""


The annual fee for the Affiliate membership is $300 based on a 12 month membership. You will be prompted to make payment upon submission of this form.

(in Canadian dollars, does not include sales tax based on your location within Canada. There is no tax outside of Canada)

Next Steps

Applications are reviewed to ensure information is accurate and treated as confidential and will not be disclosed to any person who is not a part of the review process.

You will be redirected to complete payment after the application is submitted.

All applications need to be approved, so you will not be able to log into your account immediately. Applications are approved during regular office hours.


See the Association’s privacy policy statement at