Applicant MRT Personal Info
Primary Identity and Contact Information
This information is not mandatory and is collected for statistical purposes only
The following two fields are not mandatory and the information is collected for statistical purposes only. Select your date of birth from the pop-up calendar. Click the "<" or ">" button to go backward or forward by months. Click the "<<" or ">>" button to go backward or forward by years. Click and hold any of these buttons for a drop-down selection. Click the close (X) button when the correct date is selected.
PRIMARY CONTACT INFORMATION Please provide your primary mailing address. This will be the main contact address to which official MAMRT communication will be addressed.
Mailing Address “not equal to” by “Province”
Please indicate if this is a home or work mailing address.
RESIDENCE ADDRESS Please provide the address where you reside. This field MUST NOT contain a PO Box Number. Enter a "street" name or the Manitoba legal land description.
Residence Address not equal to” by “Province”
Please provide your primary email address. This will be the main email address to which official MAMRT communication will be directed.
Please indicate if this is your home or work email address.
If you wish to receive email communication from the MAMRT at a second email address, enter it here. Email will be sent to this address in addition to the primary email address you provided above. This may be useful if you change email hosts or are subject to email storage quotas that cause messages to be lost when your mailbox gets full. By having a second address, you are less likely to miss important communication from the MAMRT.
IT IS IMPORTANT TO NOTE THAT OUR PASSWORD RETRIEVAL SYSTEM WILL SEND YOUR PASSWORD TO YOUR PRIMARY AND, IF PROVIDED HERE, SECONDARY ADDRESS. IF YOU SHARE AN EMAIL ACCOUNT WITH ANYONE (A DEPARTMENTAL ADDRESS FOR EXAMPLE) THOSE PERSONS MAY THEN HAVE ACCESS TO YOUR PASSWORD AND THEREBY YOUR PERSONAL MAMRT PROFILE.
You must enter at least one of these primary designations: RTR, RTT, RTNM, RTMR. If you hold more than one, enter them all, by selecting from the list below.
Please select the membership class for which you are applying from the list provided.
If you have selected "CAMRT/MAMRT Full Practicing" as your Member Class, please then select "Full Practicing" as your Practice Status. For all other Member Classes, please select "Inactive
Occasionally, CAMRT makes a one-time use mailing list available (including names and preferred addresses only) to third parties that may be of benefit to you as a member. This includes job recruitment, promotion of educational activities, and CAMRT Foundation fundraising activities. If you wish to opt-out of these services, you may do so by selecting Yes here.
DECLARATIONS and UNDERTAKINGS
DECLARATION AND UNDERTAKING
I declare that, to the best of my knowledge and belief, the statements made by me herein are complete and accurate. I understand that non-compliance or misrepresentation of any section may be cause for revocation of my membership. I undertake to adhere to the Constitution and Bylaws of the Manitoba Association of Medical Radiation Technologists and to notify the association within 30 days of any material change(s) to the information reported herein.
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