Post on 07-May-2020
APPLICATION FORMRETAIL ASSOCIATE MEMBER
Revised: 10/2017
Company Name: ________________________________________________________________________
Store Address: __________________________________________________________________________
City: _______________________________________________________ Postal Code: ______________
Mailing Address (if different from above): ___________________________________________________________________________
City: _______________________________________________________ Postal Code:_____________________________________
Work Phone: ________________________________________________ Fax: ____________________________________________
Toll Free: ___________________________________________________ Email: __________________________________________
Primary Contact:
Name: ____________________________________________________________ Title: _______________________________________________
Phone: ___________________________ Cell: ____________________________ Email:_______________________________________________
Yes, I would like access to Homegrown Ontario™ branding.
As a member in good standing of the Ontario Independent Meat Processors Association, I subscribe to the “Code of Conduct” as a condition of membership. Members shall; promote and foster fair trade practices in the best interests of consumers, members, suppliers, and the meat processing industry; shall maintain high standards to fully protect product safety, quality, and integrity; and shall comply with regulations and standards, as applicable to the goods and services they offer.
Signature: _______________________________________________________________ Date: _______________________________
What prompted you to join?
Collective Voice Member Discounts
Consumer Outreach Networking
Government Advocacy Technical Support
Marketing Support Training Resources
Referred by: ___________________________________ Other (specify): ___________________________________
Payment Information
Retail Associate Dues $175.00 Cheque # ___________ Enclosed (payable to the Ontario Independent Meat Processors) HST (# 121262919) $22.75 Charge to my: VISA MasterCard Expiry Date: Total Amount Due $197.75 Card #:
Membership is valid for one year from the date dues are received.
Cardholder Name: Signature:
We now accept Electronic funds transfers and E-Transfers - Call to receive deposit information. OIMP office use only: Date: ___________ Company ID #___________ Cheque/Authorization #___________ QuickBooks Processing Sheet Membership is subject to approval by the OIMP Board of Directors. Membership in the Association may be terminated at the request, in writing, of the member; when a member fails to be current with membership dues; member declares bankruptcy or dissolution of the partnership, corporation or business entity; if conduct of the member is deemed by the Board to be detrimental to the interests of the Association. An aggrieved member shall have the right of appeal to the Board of Directors . Membership fees will not be refunded in whole or in part. OIMP values the privacy of its members. All information collected is done so in accordance with our Privacy Policy. Email addresses provided on this form act as your consent to receive electronic communications from OIMP. You may request to be removed from our lists at anytime.
Additional Company Contacts: Secondary _______________________________________________ Email: ___________________________________________________
Regulatory _______________________________________________ Email: ___________________________________________________
Accounts Payable _______________________________________________ Email: ___________________________________________________
Sales/Marketing _______________________________________________ Email: ___________________________________________________
Human Resources _______________________________________________ Email: ___________________________________________________
52 Royal Rd, Unit B-1, Guelph, ON N1H 1G3 | | member@oimp.ca | oimp.caP: (519) 763-4558 F: (519) 763-4164
RETAIL ASSOCIATE MEMBER PROFILE SHEET Square Footage: _______________ Number of Employees on Payroll: _______________ Year Established: ___________________
Sales Range: Less than $250k $250k - $500k $500k - $1M $1M - $2.5M $2.5M - $5M Over $5M
*Square footage, number of employees and the sales range will not be made public.*
Please select all that apply: Product Line: BBQ Hog Beef Bison/Buffalo Deer/Elk Goat Lamb Pork
Veal Wild Boar Wild Game
Capon Chicken Cornish Hen Duck Goose Guinea Fowl Pheasant Pigeon Quail Rabbit Turkey
Fish/Seafood Pet Food
Markets Served: Catering Custom Farmers’ Market Food Service Online Private Label Wholesale
On-Site Retail: Deli Counter Fresh Counter Frozen Section Groceries Beer/Wine
Ethnic Focus: Canadian German Korean South African
Caribbean Greek Mediterranean Spanish
Chinese Hispanic Polish Ukrainian
Croatian Hungarian Portuguese Vietnamese
Dutch Indian Romanian
European Italian Russian
French Jamaican Scottish
Specialty Markets:
Gluten Free Feed Claim Halal Health Claim Kosher Natural Organic Raised Without
To benefit from OIMP’s social media strategy, please provide account names/addresses/links for the following social networks (if available):
Website: Facebook : ______
Twitter @: _________________ Instagram: ______
Business Description (max 50 words)
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Members Supporting Members: Please list your meat product suppliers:
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
Do you carry any Ontario Finest Meat Competition™ Award-Winning Products? Yes No Unsure
If yes, please list the supplier(s) and/or brand name(s)
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
I understand that the retail associate profile information I have provided is published, in a professional and positive manner, on www.ontariomeatandpoultry.ca, and in other OIMP social networks. I will notify OIMP immediately should any information change, so that you may maintain accurate records.
Thank you for supporting Ontario’s meat and poultry processors.