Applicant MRT Personal Info
Primary Identity and Contact Information
In the spaces provided below, provide your full legal first, last and middle names in proper case. Do not use a nickname or diminutive like Deb or Bill unless it is your legal first name.
Please provide any other surname(s) by which you have been known, or that may appear on your educational or certification credentials (eg. a maiden name). If more than one, separate each name by a comma (eg. Smith, Brown)
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
Please indicate if this is a home or work mailing address.

RESIDENCE ADDRESS Please provide the address where you reside.
Residence Address
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.

Please enter your home phone number. If you do not have a home phone but use a cell phone instead, enter your cell phone number as your Home Phone.
MRT SPECIFIC INFORMATION
A number is assigned to you by the Canadian Association of Medical Radiation Technologists (CAMRT) upon successful completion of an approved certification exam. If you do not have a CAMRT number or you provide an invalid or incorrect number, your application cannot proceed and approval will be delayed.
If a student, enter your CAMRT Student Contact ID
You must enter at least one of these primary designations: RTR, RTT, RTNM, RTMR. If you hold more than one, enter them all, in the order received, and separated by a comma. You may also elect to enter any Specialty Certificate credentials.
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
Enter your primary employer. For practicing MRTs, this information is used to assist your employer in verifying your membership status, certification(s), Professional Liability Insurance (PLI) coverage and/or compliance with terms of employment. If you are a non-practicing, enter 'None'.
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 By-Laws and Regulations 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.

Login Information - create or change your login
Association Management Software powered by in1touch