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Inforoute FPT Subscription Form
*Name of organization:
Organization's website:
*Address:
*Region:
Abitibi-Témiscamingue (08)
Bas-Saint-Laurent (01)
Capitale-Nationale (03)
Centre-du-Québec (17)
Chaudière-Appalaches (12)
Côte-Nord (09)
Estrie (05)
Gaspésie - Îles-de-la-Madeleine (11)
Lanaudière (14)
Laurentides (15)
Laval (13)
Mauricie (04)
Montérégie (16)
Montréal (06)
Nord-du-Québec (10)
Outaouais (07)
Saguenay - Lac-Saint-Jean (02)
HTTP link to logo:
Details about the Representative
*Name of representative:
Representative's first name:
*Representative's e-mail address:
*Representative's telephone number:
Representative's fax number:
*Representative's title:
Purchase order number for billing purposes:
Annual subscription, from July 1st to June 30th
*Organization:
Cégep or college
School board
Other educational organization
Public organization or Ministry