LIFE MEMBER APPLICATION FORM

*Place you reside for the majority of the time

Home Address

If you currently have Liability Insurance with a provider other than BFL Canada please fill out the following and include a copy the insurance policy. (please print)

Information about the Insurance Company

Total Payment (See Link for the Fee Schedule Table) Membership Fees

Refund Policy

  1. The ANBMT's member fees are fully retained and non-refundable-with the exception of extraordinary circumstances and at the discretion of the Board of Directors.
  2. The professional liability insurance (PLI) premium is fully retained by BFL Canada Insurance and non-refundable.
  3. A $5.00 administration fee is added to the PLI premium for administering the ANBMT's PLI program. This fee is fully retained by the ANBMT.
  4. There will be a $20.00 administration fee included for cheques that are returned to the ANBMT "NSF" (non-sufficient funds).

Member Fees and Professional Liability Insurance (PLI) Premiums

  1. The ANBMT's membership year commences on October 1 and ends on September 30 of the following year.
  2. All fees are to be paid directly to the ANBMT.
  3. Member fees and PLI premiums prorate each month after October 1.
  4. Payment plans may be granted in extenuating circumstances. The Board of Directors will make a determination if an extension is to be granted.
  5. .
  6. Accepted payment methods are:
    • Electronic transfer (E-transfer);
    • Cheque; or
    • Money Order
    • Credit Card (contact the ANBMT to pay using a credit card anbmt@anbmt.ca)