Application form

Contact information

Full name of the company (without acronym) *

Company email *

Company telephone *

Company website (must contain http:// or https://)

Type of Company / Organization *

Other (category)

Setting (Where are you located?) *

Address *

City *

Province *

Postal code *

Region *

First name of contact person *

Last name of contact person *

Contact person's phone number

Contact person's email address

Details on the activity offered *

Memorandum of Understanding

Commitment

To join the Companion Leisure Card (CAL) program and offer free access to the accompanying party of a person with a disability or permanent mental health problem, the manager of a tourist, cultural or recreational business or organization must complete and submit the membership form, as well as accept the Memorandum of Understanding.

Signature *

I have read and accept the Memorandum of Understanding.

Validate Email

Message important - Avant de débuter votre demande

La carte violette et la carte bleue sont acceptées.