Requesting to Have Your Membership Fee Waived

In some cases, Positive Health Network will consider waiving our annual membership fee for individuals to whom it presents a barrier. Requests are reviewed on a case-by-case basis.

This accommodation is generally available to individuals who meet one or more of the following eligibility criteria:

Individuals who are registered clients of Positive Health Network
Individuals who are current service users of Positive Health Network
Community stakeholders who self-identify as a member of one or more of Positive Health Network’s priority population groups.
Are current volunteers of Positive Health Network

Please complete the following form to sign up or renew your membership and request to have your membership fee waived. Positive Health Network may contact you to gather more information in order to help us determine your eligibility for this accommodation. Please note, to qualify for membership you must live in one of the regions served by Positive Health Network (Hamilton, Halton, Haldimand, Norfolk, Brant County or Brantford Ontario).

Waiving Membership Fee Form

Company
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Purchaser Name*
Your Full Name
Full Address*
Address
Email*
Phone*