HSLDA CANADA MEMBERSHIP RENEWAL 

If you need help filling out this form, please contact our office at 519.913.0318 for assistance.

If your current HSLDA Membership Type is Monthly or if you have chosen the annual auto-renew  and wish to update payment options, please contact our office at 519-913-0318 as this cannot be done online. 
HSLDA Membership Details

Account information can be updated on your HSLDA membersite




Primary Contact Information










Update regarding Legal Action Against any of your children



Your Discount Group Details


*By choosing a Discount Group, you give HSLDA permission to confirm, with the registered HSLDA contact of that group, that your HSLDA membership is active. (For group insurance & discount purposes only, no other information will be shared.) 
Review your Membership and Payment Information





Choose "No" to access Discount Code

Payment Information














5 digit branch or transit #

3 digit institution #(not cheque #)

8-12 digits, include zeros but not dashes, etc

Sample cheque



Hidden Form Specific Fields








Values to Submit to IATS




Contact Information