Apply to Join the PEI Women Program The information you submit will be used in the strictest of confidence to help PEI staff better serve your needs as members of this group. Once we receive this information we'll confirm your company's membership in PEI and send you details for finalizing your membership and submitting payment. Your Full Name * Title/Position Email * Company * Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year1935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010 Social Media LinkedIn Twitter Facebook Pinterest Forums Instagram Other What types of social media do you use most for professional connections? Please Specify: Source How did you hear about PEI Women? Leave this field blank
