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URISA-OC Order Form

Members: - Please login and use the members order form.

Please complete and submit the form below to purchase a product/service from URISA. You will be required to submit a payment on the next page to complete the registration process.

Order Information

*Product: Select an option Online (non-member) job posting with eBlast ($175.00) WebAd per month ($200.00) Manual Entry
* Description:
* Price: $
*First Name	*Last Name
*Company/Organization	Position
*Address Line 1	Address Line 2
*City
*Province Please Select One Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario P.E.I. Quebec Saskatchewan Yukon	*Postal Code
*Phone	Phone Ext.
*E-mail