* Organization Name:

* Representative's Name:

* Address (or PO Box):

* City/Community:

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* Is your organization based in Manitoba?
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* Does your organization employ Inuit?
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* Please state why you are interested in becoming an organizational member of MIA and how you are involved in the Inuit community of Manitoba.

As a member of the Manitoba Inuit Association, I agree to receive periodic electronic communications from the Manitoba Inuit Association that might contain topics of interest to the organization or other information they feel is relevant to its membership. I can withdraw this consent at any time.

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